About Norvasc
Norvasc belongs to a class of drugs known as calcium channel blockers.
They work by blocking calcium ions from some cell walls, inhibiting
the contraction of coronary and peripheral arteries. The reduced
electrical activity in the cardiovascular system results in
lowered oxygen requirements for the heart muscle, decreased
likelihood of spasm and contraction in the arteries, and prevents
the heart from exerting itself too rapidly or forcefully.
Benefits should be seen within 1-4 weeks of daily, consistent
use.
This medication is primarily prescribed to treat: angina
(Prinzmetal's variant angina) not caused by exertion, angina
caused by exertion in those who do not respond to treatment
with beta blockers or nitrates, angina or high blood pressure
in cases of congestive heart failure, and moderately high
blood pressure (hypertension).
Other uses for which it is acceptable include: combination
therapy with beta blockers to alleviate silent myocardial
ischemia, diabetics may use this medication to lower both
blood pressure and levels or protein in the urine, halt progression
of early artherosclerotic lesions, may stop premature labor,
provides limited migraine reduction, reduce symptoms of pulmonary
(lung) hypertension.
Medication for high blood pressure or other cardiovascular
problems may have to continue for the duration of the patient's
life, there are currently no treatments that will reverse
these conditions. It's important that medication prescribed
to treat these ailments be taken regularly, as there may be
no obvious symptoms before serious damage is done to the body.
This medication will work best when combined with a diet low
in salt and harmful fats, and a moderate exercise program
as determined by a health professional.
Norvasc is only available by prescription, carefully follow
your doctors instructions for best results.
Norvasc Side Effects
Possible Side Effects: Flushing, low blood pressure
(hypotension), sexual dysfunction, swelling of feet or ankles,
swelling of male breast (case report), warmth.
Adverse Side Effects: Report any of the following infrequent
to rare symptoms to your doctor. If you experience any serious side
effects, seek medical treatment.
Mild: Allergy (rash), altered vision (double vision
or pain), constipation, coughing, dizziness, fatigue, flushing,
headache, heart palpitations, increased nighttime urination,
indigestion, nausea, poor circulation to extremities (cold
or numbness in hands or feet), ringing in the ears, unusual
conditions of the gums (bleeding, growth, tenderness), wheezing.
Serious: Allergy (erythema multiforme, exfoliative
dermatitis, severe rash), difficulty breathing, edema (swelling),
low white blood cell count, movement disorder or tremor, rebound
angina (abrupt stoppage).
Overdose: Acidosis, fainting, heart attack, low blood
pressure, sinus arrest, seizure, slow or racing heartbeat,
weakness. Seek emergency medical attention at once, only take
your prescribed dosage.
Cautions: This medication may not be suitable for everyone.
Discuss any history of the following conditions with your doctor,
and carefully examine your treatment options.
- Allergies: An allergic reaction to this drug in
the past is an indication that you should not use it. Inform
you doctor if you have had a poor response to another calcium
channel blocker, or have any other allergies (food, dye,
medications).
- Atrioventricular Block: Speak to a specialist regarding
treatment options.
- Congestive Heart Failure/2nd or 3rd Degree Heart Block:
You should not use this medication.
- Gangrene: Discuss use with your doctor.
- Glaucoma: If you have glaucoma, and must administer
any of the following beta blocker eye drops, consult your
physician regarding possible interactions: Betagan (levobunolol),
Betoptic (betaxolol), OptiPranolol (metipranolol), or Timoptic
(timolol).
- Heart Medications: If you take any other medication
for a cardiovascular condition, there may be a risk of significant,
possibly dangerous, drug interactions. Nitroglycerin and
other nitrate drugs, however, are safe to use.
- Kidney or Liver Disease: Your doctor may decrease
the normal dose from 20-75%, depending on the severity of
the condition. Norvasc should not be prescribed for individuals
with active liver disease. In rare cases, this drug has
caused liver damage, and should be prescribed with caution
to individuals whose livers have been damaged by other drugs.
- Left Ventricle Dysfunction: Do not use.
- Low Blood Pressure (Hypotension): Do not use.
- Muscular Dystrophy: Speak with your doctor.
- Poor Circulation: Frequently cold or tinging extremities
should be discussed with your doctor.
- Recent Heart Attack: Use with caution.
- Recent Stroke: Use with caution.
- Sick Sinus Syndrome: If your condition has not
been treated with a pacemaker, this medication should not
be prescribed.
- Ventricular Tachycardia: A fast heart rate that's
a result of ventricular activity should not be treated with
Norvasc, and is a contraindication for treatment.
Norvasc Interactions
This medication may interact with other treatments. Always keep
your prescribing physician informed about any prescription or over
the counter preparations you may use. While some of the following
medications may be used with amlodipine even though there is a possibility
for interaction, some should not be mixed. Your doctor will have
to make this determination based on the necessity of treatment,
the possibility of dosage adjustments, and your medical history.
- Alcohol - Use with caution as directed by your doctor.
Alcohol may lower blood pressure too much, and its side
effects may be more pronounced when used with this medication.
- Azole antifungals - Diflucan
(fluconazole), Nizoral
(ketoconazole), Sporanox
(itraconazole), and possibly others, may cause amlodipine
toxicity.
- Beta Blockers - Drugs like Blocadren (timolol), Cartrol
(carteolol), Corgard (nadolol), Inderal
(propranolol), Kerlone (betaxolol), Levatol (penbutolol),
Lopressor (metoprolol),
Normodyne (labetalol), Sectral (acebutolol), Sotacor (sotalol),
Tenormin (atenolol),
Trasicor (oxprenolol ), or Visken (pindolol) may alter heart
rhythm and blood pressure undesirably when used with calcium
channel blockers. The beta blocker drops administered by
eye as a treatment for glaucoma may also interact with amlodipine,
speak to your doctor if you take Betagan (levobunolol),
Betoptic (betaxolol), OptiPranolol (metipranolol), or Timoptic
(timolol) drops.
- Calcium - Supplemental calcium may reduce the effectiveness
of calcium channel blockers. Take any vitamin supplement
containing calcium either 2 hours before, or 2 hours after,
taking your medicine.
- Cordarone (amiodarone) - This combination may cause cardiac
arrest.
- Coumadin (warfarin)
- Increased risk of gastrointestinal hemorrhage.
- Digitalis glycosides - Toxicity may occur when these compounds
are combined with calcium channel blockers.
- Nicotine (chewing tobacco, cigarettes, nicotine gum or
patches) - This substance may reduce the effectiveness of
your treatment. Do not combine.
- Non-steroidal anti-inflammatories (NSAIDs) like Ibuprofen,
Indocin (indomethacin), Naprosyn (naproxen), and others,
as well as combination pain killers which contain NSAIDs,
may reduce the medication's effectiveness in reducing high
blood pressure.
- Norpace (disopyramide) - Undesirable amlodipine buildup
may occur. Increased muscle weakness may occur when these
treatments are combined.
- Pronestyl (procainamide) - Calcium channel blockers can
increase the effects of this drug.
- Protease inhibitors such as Agenerase (amprenavir), Norvir
(ritonavir), and perhaps others, may lead to higher levels
of amlodipine in the body.
- Quinaglute (quinidine) - Calcium channel blockers increase
the risk of quinidine side effects.
- Rescriptor (delavirdine) - May cause toxic buildup of
amlodipine.
- Rifampin (Rifadin, Rimactane) - May decrease usefulness
of amlodipine.
- Sandimmune (cyclosporine) - Increased risk of side effects.
- Synercid (dalfopristin, quinupristin) - The effects of
amlodipine may be increased.
- Tagamet (cimetidine)
- Can increase amlodipine's effects.
- Tegretol (carbamazepine)
- Tegretol may build up to toxic levels in the body.
- Tikosyn (dofetilide) - Dosage adjustments may be necessary
to prevent Tikosyn toxicity.
Norvasc Dosages
Amlodipine is available in the following dosages and forms
of delivery:
- Lotrel combination tablets with Lotensin (benazepril),
amlodipine/benazepril : 2.5 mg/10 mg, 5 mg/10 mg, 5 mg/20
mg
- Norvasc (amlodipine) tablets: 2.5 mg, 5 mg, 10 mg
The following are general guidelines for adults, your doctor
will need to give you a specific dosage depending on your
body size and medical history. Dosage should not generally
exceed 10 mg daily. Your doctor will probably start with the
minimum dose and gradually increase as needed, follow your
doctor's instructions for use exactly.
- Angina: 5 mg - 10 mg daily, in a single dose.
- Congestive heart failure: 5 mg for two weeks, in a single
daily dose. After that, dosage may be increased to 10 mg
daily, as seems prudent and necessary.
- Hypertension: 2.5 mg - 10 mg daily, in a single dose,
or as two equal doses of Lotrel.
Norvasc Directions
If you miss a dose of Norvasc, take it as soon as you remember,
unless it is almost time for the next one. In that case, skip
the missed dose and go back to your schedule. Do not take
double doses of amlodipine. This medication is most effective
when it is used consistently according to the schedule recommended
by your doctor.
Norvasc and Lotrel tablets are most comfortably taken with
food. The tablets may be crushed into food or a beverage.
Do not take this medication within two hours of a calcium
supplement.
Stopping this Norvasc abruptly may lead to rebound angina. Decrease
your dose gradually according to the advice of your doctor if you
must stop treatment for any reason.
Store Norvasc away from direct light and heat. Store in a dry
location; avoid storing it in the bathroom, near sinks, or other
areas where it may become damp. Do not use after the expiration
date.
Keep Norvasc away from children; both when storing it, and when
discarding any unused medication.
Norvasc and Pregnancy
In animal studies, this medication caused a greater incidence
of growth problems with the unborn child, but did not cause
birth defects. Norvasc should not be used at all during the
first trimester, consult with your doctor about treatment
during the rest of your pregnancy. Lotrel should not be used
during pregnancy at all, as the ACE inhibitor component can
be highly damaging during the last two trimesters of pregnancy.
Inform your doctor if you are planning a pregnancy, use effective
contraception while taking.
This drug only appears in very small quantities in breast milk.
If you wish to combine treatment with breastfeeding, consult with
your doctor and monitor your child's condition.
Norvasc and Children
This medication has not been established as as safe and effective
treatment for children under 12 years of age.
Norvasc and Seniors
There is a greater likelihood of dizziness, fainting, falls,
or weakness. Changes in thirst or urination should be reported
to your doctor immediately. Daily dose may be limited to 2.5
mg daily in very frail patients, but in all cases, the smallest
possible doses will be used.
Norvasc is a trademark of Pfizer
Lotrel is a trademark of Novartis
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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