Description
Release form
Tablets.
Packing
30 pcs.
Pharmacological action
Antianginal, antihypertensive. Norvask blocks the flow of calcium ions through membranes into the smooth muscle cells of the myocardium and blood vessels (calcium channels). Vasodilation leads to a decrease in blood pressure. The antianginal effect is due to both a decrease in O2 consumption due to the expansion of arterioles and a decrease in OPSS (afterload), and an increase in O2 delivery due to dilatation of the main coronary arteries and arterioles in ischemic and unchanged myocardial zones.
Contraindications
Hypersensitivity (including to other dihydropyridines).
Pregnancy and lactation
Not recommended.
Special instructions
Norvask is used with caution in case of renal failure, impaired liver function. Do not prescribe to children (no experience with use).
Composition
1 tablet contains amlodipine (as besilate) 10 mg.
Dosage and administration of
Norvask is taken orally. With arterial hypertension and angina pectoris, the initial dose is 5 mg once a day. It is possible to increase it to a maximum dose of 10 mg, depending on the individual response of the patient.
Side effects
Headache, swelling, fatigue, drowsiness, nausea, abdominal pain, hot flashes, palpitations and dizziness less often – dyspepsia, arthralgia, asthenia, shortness of breath, gingival hyperplasia, gynecomastia, impotence, changes in frequency, urination muscle, myalgia, pruritus, rashes, visual disturbances rarely – erythema multiforme, jaundice and an increase in hepatic transaminases.
Drug Interactions
Expected to be that inhibitors of microsomal oxidation will increase the concentration of amlodipine in plasma, increasing the risk of side effects, and inducers of microsomal enzymes of the liver will decrease.
Cimetidine: with the simultaneous use of amlodipine with cimetidine, the pharmacokinetics of amlodipine does not change.
Grapefruit juice: simultaneous administration of 240 ml of grapefruit juice and 10 mg of amlodipine orally is not accompanied by a significant change in the pharmacokinetics of amlodipine.
Unlike other BMCC, the clinically significant interaction of the drug Norvask (3rd generation BMCC) was not found when combined with non-steroidal anti-inflammatory drugs (NSAIDs), especially indomethacin.
May enhance the antianginal and hypotensive effects of BMCC when combined with thiazide and loop diuretics, verapamil, ACE inhibitors, beta-blockers and nitrates, as well as an increase in their hypotensive effect when combined with alpha-1-blockers, antipsychotics.
Although a negative inotropic effect was not usually observed when studying the drug Norvask, nevertheless, some BMCCs can increase the severity of the negative inotropic effect of antiarrhythmic drugs that cause a prolongation of the QT interval (for example, amiodarone and quinidine).
When combined with BMCC and lithium preparations (no data for Norvask), their neurotoxicity (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus) may increase.
Amlodipine does not affect in vitro the degree of digoxin, phenytoin, warfarin, and indomethacin plasma protein binding.
Aluminum / Magnesium containing antacids: their single administration does not significantly affect the pharmacokinetics of amlodipine.
Sildenafil (Viagra): a single dose of 100 mg of sildenafil in patients with essential hypertension does not affect the pharmacokinetics of amlodipine.
Atorvastatin: repeated use of amlodipine at a dose of 10 mg and atorvastatin at a dose of 80 mg is not accompanied by significant changes in the pharmacokinetics of atorvastatin.
Digoxin: with the simultaneous use of amlodipine with digoxin in healthy volunteers, serum levels and renal digoxin clearance do not change.
Ethanol (alcohol-containing drinks): with a single and repeated use at a dose of 10 mg, amlodipine does not significantly affect the pharmacokinetics of ethanol.
Warfarin: Amlodipine does not affect changes in prothrombin time caused by warfarin.
Cyclosporine: Amlodipine does not cause significant changes in cyclosporine pharmacokinetics.
overdose
Symptoms: marked decrease in blood pressure with possible development of reflex tachycardia and excessive peripheral vasodilation (there is a likelihood of pronounced and persistent arterial hypotension, including the development of shock and lethal outcome).
Treatment: appointment of activated charcoal (especially in the first 2 hours after overdose), gastric lavage (in some cases), elevation of the limbs, active maintenance of cardiovascular function, monitoring of heart and lung performance, control of circulating blood volume and diuresis.
Use of vasoconstrictor drugs may be helpful to restore vascular tone and blood pressure, if not contraindicated. Use intravenous calcium gluconate. Because amlodipine is highly bound to serum proteins, hemodialysis is not effective.
Storage Conditions
In a dark place at a temperature not exceeding 20 ° C.
prescription
Prescription
lekarstvennaja form
tablets
