Adult Dosing

Hypertension

• Initial dose: 5 mg PO qd
• Max dose: 10 mg qd
• Start on 2.5 mg qd and use this dose when adding amlodipine to other antihypertensive therapy in small, fragile, or geriatrics, or patients with hepatic insufficiency
• Individualize dosage and titrate over 1-2 wks

Chronic stable or vasospastic angina, angiographically documented coronary artery disease in patients without heart failure or an ejection fraction <40%

• 5-10 mg PO qd
• Start with lower dose in geriatrics, or in patients with hepatic insufficiency

Pediatric Dosing

Hypertension

• 6-17 yrs
• 2.5-5 mg PO qd
• Max dose: 5 mg/day

[Outline]

• Adult Dosing
• Pediatric Dosing

• As monotherapy or in combination with other antihypertensive and antianginal agents for the treatment of hypertension
• As monotherapy or in combination with other antihypertensive and antianginal agents for the treatment of coronary artery disease
• Chronic stable angina
• Vasospastic angina (Prinzmetal’s or Variant angina)
• Angiographically documented coronary artery disease in patients without heart failure or an ejection fraction < 40%

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Start with 2.5 mg PO qd

• Symptomatic hypotension has occurred particularly in patients with severe aortic stenosis
• Worsening of angina and acute myocardial infarction have occurred after starting or increasing the dose particularly in patients with severe obstructive CAD
• Titrate dose slowly in patients with severe hepatic insufficiency

Cautions: Use cautiously in

• Hepatic impairment
• CHF
• Severe CAD
• Severe aortic stenosis
• Geriatrics

Norvasc interacts with :

	Agenerase
	Akne-mycin
	Amiodarone
	Amprenavir
	Aprepitant
	Atazanavir
	Barbiturates
	Biaxin
	Biaxin XL
	Bosentan
	Carbamazepine
	Carbatrol
	Clarithromycin
	Conivaptan
	Cordarone
	Crixivan
	Cyclosporine
	Darunavir
	Delavirdine
	Diflucan
	Dilantin
	Dilantin Infatabs
	Dilantin-125
	Dronedarone
	E-Mycin
	E.E.S.
	Efavirenz
	Emend
	Epitol
	Equetro
	Ery-Tab
	Eryc
	Erygel
	Eryped
	Erythra-Derm
	Erythro-statin
	Erythrocin
	Erythromycin
	Extina
	Fluconazole
	Fluvoxamine
	Gengraf
	Grapefruit
	Indinavir
	Invirase
	Itraconazole
	Ketek
	Ketoconazole
	Luvox
	Luvox CR
	Multaq
	Mycobutin
	Mysoline
	Nafcillin
	Nallpen
	Nefazodone
	Nelfinavir
	Neoral
	Nevirapine
	Nexterone
	Nizoral
	Nizoral A-D Shampoo
	Nizoral Shampoo
	Norvir
	Noxafil
	Onmel
	Oxcarbazepine
	Oxtellar XR
	Pacerone
	PCE
	Pediamycin
	Phenytek
	Phenytoin
	Posaconazole
	Prezista
	Priftin
	Primidone
	Quinupristin
	Rescriptor
	Restasis
	Reyataz
	Rifabutin
	Rifadin
	Rifampin
	Rifapentine
	Rimactane
	Ritonavir
	Sandimmune
	Saquinavir
	Sporanox
	St. John's Wort
	Sustiva
	Synercid
	TAO
	Tegretol
	Tegretol XR
	Telithromycin
	Teril
	Tracleer
	Trileptal
	Troleandomycin
	Unipen
	Vaprisol
	Vfend
	Viracept
	Viramune
	Viramune XR
	Voriconazole
	Xolegel

Pregnancy Category:C

Breastfeeding: Possibly unsafe; Prefer an alternative drug during breastfeeding as appropriate literature on the use of amlodipine is unavailable. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 30 December 2010). Unknown whether amlodipine is excreted in human milk. Manufacturer advises to discontinue nursing.

• CV: Exacerbation of angina, MI, hypotension, peripheral edema, palpitations
• CNS: Fatigue, dizziness
• GI: Acute hepatitis, nausea
• DERM: Erythema multiforme, flushing
• MISC: Allergic reactions

• Calcium channel blocker; inhibits the transmembrane influx of calcium ions into coronary vascular smooth muscle and cardiac muscle
• Absolute bioavailability: 64-90%
• Extensively metabolized by liver; CYP450: CYP3A4
• Excreted in urine 59-62% (5-10% unchanged), bile/feces 20-25%
• Half-life: 30-50 hrs, 56hrs (impaired renal function)

US Trade Name(s)

• Norvasc

US Availability

amlodipine (generic)

• TABS: 2.5, 5, 10 mg

Norvasc

• TABS: 2.5, 5, 10 mg

Canadian Trade Name(s)

• Norvasc

Canadian Availability

amlodipine (generic)

• TABS: 2.5, 5, 10 mg

Norvasc

• TABS: 2.5, 5, 10 mg

UK Trade Name(s)

• Amlostin
• Istin

UK Availability

Amlostin, Istin

• TABS: 5, 10 mg

Australian Trade Name(s)

• Norvasc
• Ozlodip
• Perivasc

Australian Availability

Norvasc, Ozlodip, Perivasc

• TABS: 5, 10 mg

[Outline]

Cardiovascular

Antihypertensive Agents

Calcium Channel Blockers

Pricing data from www.DrugStore.com in U.S.A.

• Norvasc 10 MG TABS [Bottle] (PFIZER U.S.)
  30 mg = $107.99
  90 mg = $299.96
• Norvasc 2.5 MG TABS [Bottle] (PFIZER U.S.)
  30 mg = $80.99
  90 mg = $220.96
• Norvasc 5 MG TABS [Bottle] (PFIZER U.S.)
  30 mg = $80.99
  90 mg = $225.96

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (American Health Packaging)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Amneal Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Breckenridge Pharmaceutical, Inc.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (CARACO PHARMACEUTICAL LABORATORIES, LTD.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Cadila Healthcare Limited)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Contract Pharmacy Services-PA)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Dr Reddy's Laboratories)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Greenstone LLC)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Kali Laboratories, Inc., A Wholly Owned Subsidiary of Par Pharmaceutical Companies)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Major Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Mylan Pharmaceuticals Inc.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Physicians Total Care, Inc.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Qualitest Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Roxane Laboratories, Inc)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (State of Florida DOH Central Pharmacy)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Synthon Pharmaceuticals, Inc.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Torrent Pharmaceuticals Limited)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (UDL Laboratories, Inc.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Upsher-Smith Laboratories, Inc.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (WOCKHARDT USA LLC.)
• Amlodipine (as amlodipine besylate) 10 MG Oral Tablet (Zydus Pharmaceuticals (USA) Inc.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (American Health Packaging)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Amneal Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Breckenridge Pharmaceutical, Inc.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (CARACO PHARMACEUTICAL LABORATORIES, LTD.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Cadila Healthcare Limited)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Dr Reddy's Laboratories)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Glenmark Generics Inc., USA)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Greenstone LLC)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Kali Laboratories, Inc., A Wholly Owned Subsidiary of Par Pharmaceutical Companies)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Major Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Mylan Pharmaceuticals Inc.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Physicians Total Care, Inc.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Qualitest Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Roxane Laboratories, Inc)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Synthon Pharmaceuticals, Inc.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Torrent Pharmaceuticals Limited)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (UDL Laboratories, Inc.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Upsher-Smith Laboratories, Inc.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (WOCKHARDT USA LLC.)
• Amlodipine (as amlodipine besylate) 2.5 MG Oral Tablet (Zydus Pharmaceuticals (USA) Inc.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (American Health Packaging)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Amneal Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Breckenridge Pharmaceutical, Inc.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (CARACO PHARMACEUTICAL LABORATORIES, LTD.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Cadila Healthcare Limited)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Dr Reddy's Laboratories)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Glenmark Generics Inc., USA)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Greenstone LLC)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Kali Laboratories, Inc., A Wholly Owned Subsidiary of Par Pharmaceutical Companies)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Major Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Mylan Pharmaceuticals Inc.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Physicians Total Care, Inc.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Qualitest Pharmaceuticals)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Roxane Laboratories, Inc)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (STAT RX USA LLC)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (State of Florida DOH Central Pharmacy)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Synthon Pharmaceuticals, Inc.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (TEVA Pharmaceuticals USA Inc)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Torrent Pharmaceuticals Limited)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (UDL Laboratories, Inc.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Upsher-Smith Laboratories, Inc.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (WOCKHARDT USA LLC.)
• Amlodipine (as amlodipine besylate) 5 MG Oral Tablet (Zydus Pharmaceuticals (USA) Inc.)
• Norvasc 10 MG Oral Tablet (Pfizer Laboratories Div Pfizer Inc)
• Norvasc 2.5 MG Oral Tablet (Pfizer Laboratories Div Pfizer Inc)
• Norvasc 5 MG Oral Tablet (Pfizer Laboratories Div Pfizer Inc)