lāt),drug class: calcium channel blocker;
action: inhibits calcium ion influx across cell membrane during cardiac depolarization; produces relaxation of coronary vascular smooth muscle and dilates coronary arteries; decreases SA/AV node conduction;
uses: hypertension as a single agent or in combination with other antihypertensives, chronic stable angina pectoris, vasospastic angina.
amlodipine besylate
Norvasc
Pharmacologic class: Calcium channel blocker
Therapeutic class: Antihypertensive
Pregnancy risk category C
Action
Inhibits influx of extracellular calcium ions, thereby decreasing myocardial contractility, relaxing coronary and vascular muscles, and decreasing peripheral resistance
Availability
Tablets: 2.5 mg, 5 mg, 10 mg
⊘Indications and dosages
➣ Essential hypertension, chronic stable angina pectoris, and vasospastic angina (Prinzmetal's angina)
Adults: 5 to 10 mg P.O. once daily
Dosage adjustment
• Hepatic impairment
• Elderly patients
Off-label uses
• Pulmonary hypertension
• Raynaud's disease
Contraindications
• Hypersensitivity to drug
Precautions
Use cautiously in:
• aortic stenosis, severe hepatic impairment, heart failure
• elderly patients
• pregnant or breastfeeding patients.
• children.
Administration
• Be aware that this drug may be given alone or with other drugs to relieve hypertension or angina.
| Route | Onset | Peak | Duration |
| P.O. | Unknown | 6-9 hr | 24 hr |
Adverse reactions
CNS: headache, dizziness, drowsiness, light-headedness, fatigue, weakness, lethargy
CV: peripheral edema, angina, bradycardia, hypotension, palpitations
GI: nausea, abdominal discomfort
Musculoskeletal: muscle cramps, muscle pain or inflammation
Respiratory: shortness of breath, dyspnea, wheezing
Skin: rash, pruritus, urticaria, flushing
Interactions
Drug-drug. Beta-adrenergic blockers: increased risk of adverse effects
Fentanyl, nitrates, other antihypertensives, quinidine: additive hypotension
Drug-behaviors. Acute alcohol ingestion: additive hypotension
Patient monitoring
☞ Monitor patient for worsening angina.
• Monitor heart rate and rhythm and blood pressure, especially at start of therapy.
☞ Assess for heart failure; report signs and symptoms (peripheral edema, dyspnea) to prescriber promptly.
☞ Give sublingual nitroglycerin, as prescribed, if patient has signs or symptoms of acute myocardial infarction (especially when dosage is increased).
Patient teaching
• If patient also uses sublingual nitroglycerin, tell him he can take nitroglycerin as needed for acute angina.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant adverse reactions, especially those related to the drugs and behaviors mentioned above.
amlodipine besylate
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