Norvasc tablets 5 mg No. 10x3

Pharmacological properties of the drug Norvasc

Amlodipine (3-ethyl-5-methyl-2-(2-amino-ethoxymethyl)-4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5-pyridinedicarboxylate benzenesulfonate) is a calcium ion antagonist ( blocker of slow calcium channels of cell membranes). Blocks the entry of calcium ions into the smooth muscle cells of the myocardium and blood vessels. The mechanism of the hypotensive effect of amlodipine is due to a direct effect on vascular smooth muscle. The antianginal effect of amlodipine is realized in two ways:

amlodipine dilates peripheral arterioles and thus reduces afterload. Since heart rate remains virtually unchanged, a decrease in afterload on the heart leads to a decrease in energy consumption and myocardial oxygen demand;
amlodipine directly dilates coronary arteries of different calibers both in unchanged and ischemic areas of the myocardium. This dilation increases the supply of oxygen to ischemic areas in patients with vasospastic angina (Prinzmetal's angina or variant angina) and prevents the development of coronary vasoconstriction.

In patients with hypertension (arterial hypertension), a single dose of amlodipine provides a clinically significant reduction in blood pressure within 24 hours both in the supine and standing positions. Due to the gradual onset of action, amplodipine does not cause the development of symptomatic hypotension. In patients with angina pectoris, a single dose of amlodipine increases the time of physical activity, delays the development of an attack of angina and ST during physical activity, reduces the frequency of angina attacks and reduces the need to take nitroglycerin. in vitro studies indicate that approximately 97.5% of amlodipine is bound to plasma proteins. Amlodipine does not have a negative effect on metabolism and the lipid spectrum of blood plasma; it can be used to treat patients with asthma, diabetes mellitus and gout. As a result of hemodynamic studies and controlled clinical trials in patients with heart failure II–III functional class (FC) according to the NYHA classification, it was revealed that amlodipine does not cause a deterioration in the condition of patients according to such criteria as exercise tolerance, left ventricular ejection fraction and clinical symptoms. In placebo-controlled studies evaluating patients with heart failure (NYHA class III-IV) treated with digoxin, diuretics and ACE inhibitors, it was found that amlodipine did not increase the mortality rate or composite mortality rate in patients with heart failure . After oral administration, amlodipine is well absorbed from the digestive tract, reaching maximum plasma concentrations after 6–12 hours. Bioavailability is 64–80%. The volume of distribution is approximately 21 l/kg. Food intake does not affect the absorption of amlodipine. The half-life is approximately 35–50 hours, which allows the drug to be administered once a day. A stable equilibrium concentration in the blood plasma is achieved after 7–8 days of continuous use of the drug. Amlodipine is biotransformed in the liver with the formation of inactive metabolites; 10% of the unchanged drug and 60% of the metabolites are excreted in the urine. In the elderly and in patients with congestive heart failure, there is a tendency for the clearance of amlodipine to decrease, which leads to an increase in AUC and half-life.

Instructions for use NORVASC

2. The mechanism of action of amlodipine probably also includes dilation of the main coronary arteries and coronary arterioles in both unchanged and ischemic areas of the myocardium. This dilatation increases the supply of oxygen to the myocardium in patients with vasospastic angina (Prinzmetal's angina or variant angina) and prevents the development of coronary vasoconstriction caused by smoking.

In patients with arterial hypertension, a single daily dose of amlodipine provides a clinically significant reduction in blood pressure over 24 hours, both in the supine and standing positions. Due to its slow onset of action, amlodipine does not cause acute arterial hypotension.

In patients with angina pectoris, a single daily dose of amlodipine increases the time of physical activity, delays the development of an angina attack and ST segment depression (by 1 mm) during exercise, reduces the frequency of angina attacks and the consumption of nitroglycerin tablets.

Amlodipine does not have a negative effect on metabolism and the lipid profile of blood plasma, so it is suitable for the treatment of patients with bronchial asthma, diabetes mellitus and gout.

Use in patients with coronary artery disease

The effects of amlodipine on cardiovascular morbidity and mortality, progression of coronary atherosclerosis and the course of carotid atherosclerosis were studied in the Prospective Randomized evaluation of the Vascular Effects of NORVASC - PREVENT. This multicenter, randomized, double-blind, placebo-controlled study followed 825 patients with angiographically confirmed coronary atherosclerosis for 3 years. The study included patients who had undergone myocardial infarction (45%), percutaneous transluminal coronary angioplasty (PCA) (42%), or suffered from angina pectoris (69%). The severity of IHD varied from damage to one vessel (45% of patients) to stenosis of 3 or more arteries (21%). Patients with uncontrolled hypertension (diastolic blood pressure > 95 mmHg) were excluded from the study. The presence of major cardiovascular events was confirmed by a blinded endpoint committee. Although the incidence of progression of coronary atherosclerosis did not change, amlodipine prevented progressive carotid intima-media thickening. In patients receiving amlodipine, there was a significant reduction (by 31%) in the total incidence of death from cardiovascular causes, myocardial infarction, stroke, TLP, coronary artery bypass grafting, hospitalization for unstable angina, and progression of congestive heart failure. In addition, in patients in the amlodipine group, the frequency of interventions aimed at restoring coronary blood flow (TLP and coronary artery bypass grafting) decreased significantly (by 42%). When treated with amlodipine, the incidence of hospitalization for unstable angina was lower (by 33%) than in the placebo group.

Use in patients with heart failure

Hemodynamic studies and controlled clinical studies using exercise testing have shown that amlodipine does not cause deterioration in patients with NYHA functional class II-IV heart failure, as evidenced by the study of exercise tolerance, left ventricular ejection fraction and clinical symptoms.

In a placebo-controlled study (PRAISE), which included patients with NYHA functional class III-IV heart failure treated with digoxin, diuretics and ACE inhibitors, amlodipine did not increase the risk of death or the total risk of complications and death.

In a long-term placebo-controlled study (PRAISE-2) in patients with NYHA functional class III-IV heart failure without clinical or objective signs of coronary heart disease who received ACE inhibitors, cardiac glycosides and diuretics in constant doses, amlodipine had no effect on overall and cardiovascular mortality. In the same population, amlodipine was associated with an increased incidence of pulmonary edema, although the incidence of progression of heart failure was not significantly different from placebo.

Indications for use of the drug Norvasc

Treatment of hypertension (arterial hypertension) (as a first-line drug as monotherapy or combination therapy in combination with thiazide diuretics, α- and β-adrenergic receptor blockers, ACE inhibitors). Treatment of coronary artery disease, namely stable angina and vasospastic angina (variant angina or Prinzmetal angina). Reducing the risk of the need for myocardial revascularization and hospitalization for angina pectoris in patients with coronary artery disease. The drug can be used in cases where the clinical picture suggests the presence of vasospasm or vasoconstriction, although their presence has not been confirmed. Used as monotherapy or in combination with other antianginal drugs.

Side effects of the drug Norvasc

In placebo-controlled clinical trials involving patients with hypertension (arterial hypertension) and angina pectoris, the most commonly reported symptoms were headache, peripheral edema, fatigue, drowsiness, nausea, abdominal pain, flushing, palpitations and dizziness. In these clinical studies, no clinically significant changes in laboratory parameters due to Norvasc were noted. Significantly less often, with the widespread use of Norvasc, side effects such as alopecia, constipation, arthralgia, asthenia, back pain, dyspepsia, shortness of breath, gum hyperplasia, gynecomastia, hyperglycemia, impotence, increased frequency of urination, leukopenia, general malaise, mood changes, sensation were observed. dry mouth, convulsions, myalgia, peripheral neuropathy, pancreatitis, sweating, fainting, thrombocytopenia, vasculitis. In most cases, the causal relationship was unreliable. Allergic reactions have been reported rarely, including pruritus, rash, angioedema and erythema multiforme. Very rarely, when using the drug, hepatitis, jaundice and increased activity of liver enzymes (usually due to cholestasis) were observed. In most of these cases, the causal relationship was not reliable. As with the use of other calcium ion antagonists, isolated cases of myocardial infarction, arrhythmias (including ventricular tachycardia and atrial fibrillation), as well as chest pain have been described with the use of Norvasc.

Special instructions for the use of Norvasc

The half-life of Norvasc increases in patients with impaired liver function, however, recommendations regarding the dosage regimen of the drug in this group of patients have not been developed, for this reason the drug should be used in them with caution. The recommended dose for patients with liver failure is 2.5 mg. In patients with renal failure, Norvasc is used in normal doses. Changes in plasma concentrations of amlodipine do not correlate with the severity of renal failure. Amlodipine is not eliminated by dialysis. Elderly patients tolerate the drug well; The recommended dose for them is 2.5 mg/day. The safety of using Norvasc during pregnancy and lactation has not been established. The drug can be used during pregnancy only if there is no safer alternative, and the risk caused by the disease itself outweighs the possible negative consequences of using the drug for the mother and fetus. The effectiveness and safety of Norvasc in children has not been studied. It is unlikely that Norvasc can have a negative effect on the ability to drive vehicles or operate potentially dangerous machinery.

Norvasc.

Release forms

Tablets.

INN

Amlodipine.

FTG

Bmkk.

Pharmacotherapeutic group

Calcium channel blockers. Selective calcium channel blockers with a predominant effect on blood vessels. Dihydropyridine derivatives. ATX code: C08CA01.

What is Norvasc and in what cases is this drug used?

The active substance of Norvasc, amlodipine, belongs to a group of drugs called calcium channel blockers. Norvasc is used to treat high blood pressure (hypertension) or a certain type of chest pain called angina, including a rare form called Prinzmetal's angina or variant angina. In patients with high blood pressure, this medicine causes blood vessels to relax, thereby making it easier for blood to pass through them. In patients with angina pectoris, Norvasc improves blood supply to the heart muscle and accordingly increases the supply of oxygen to it, thereby preventing the occurrence of chest pain. This drug does not provide immediate relief from chest pain caused by angina.

Do not take the drug

• If you are allergic (hypersensitivity) to amlodipine or any of the ingredients included in the drug and listed in the Composition section, or any other drugs from the group of calcium channel blockers. Symptoms may include itching, redness of the skin, or difficulty breathing. • If you have very low blood pressure (hypotension). • If you have a narrowed aortic valve (aortic stenosis) or have developed cardiogenic shock (a condition in which the heart is unable to supply enough blood to the body's organs). • If you have developed heart failure after a myocardial infarction.

Directions and precautions

Before taking Norvasc, you should consult your doctor or pharmacist. If you have or have previously developed the following conditions, you should tell your doctor: • recent myocardial infarction; • heart failure; • marked increase in blood pressure (hypertensive crisis); • liver disease; • You are an elderly person and you need to increase the dose of the drug.

Children and teenagers

The use of Norvasc in children under 6 years of age has not been studied. Norvasc should only be used to treat hypertension in children and adolescents aged 6 to 17 years (see How to take). For more information, contact your healthcare provider. Sodium content The sodium content of this medicinal product is less than 1 mmol (23 mg) per tablet, i.e. it is actually “sodium-free.”

Other medicines

Tell your doctor or pharmacist if you are currently taking or have recently taken any other medicines, including over-the-counter medicines. Norvasc may affect or be affected by other medicines you are taking, such as: • ketoconazole, itraconazole (antifungal medicines); • ritonavir, indinavir, nelfinavir (so-called protease inhibitors used to treat HIV infection); • rifampicin, erythromycin, clarithromycin (antibiotics); • Hypericum perforatum (preparations containing St. John's wort); • verapamil, diltiazem (heart medications); • dantrolene (in the form of infusion with a pronounced increase in body temperature); • tacrolimus, sirolimus, temsirolimus and everolimus (medicines used to change the way the immune system works); • simvastatin (a cholesterol-lowering medicine); • cyclosporine (immunosuppressant). Norvasc may lower blood pressure more significantly when you take other medicines to treat high blood pressure at the same time. Taking Norvasc with food and drinks Patients taking Norvasc should not eat grapefruit or grapefruit juice. This is due to the fact that when taking grapefruit and grapefruit juice, the concentration of the active ingredient amlodipine in the blood increases, which can lead to an unpredictable increase in the hypotensive effect of the drug Norvasc.

Pregnancy and breastfeeding

Pregnancy The safety of amlodipine in women during pregnancy has not been established. If you think you may be pregnant or are planning a pregnancy, you should tell your doctor before you start taking Norvasc. Breastfeeding It has been established that amlodipine passes into breast milk in small quantities. If you are breastfeeding or intend to start breastfeeding, you should tell your doctor before you start taking Norvasc. Before taking any medicine, consult your doctor or pharmacist.

Impact on the ability to drive vehicles and operate machinery

Norvasc may affect the ability to drive vehicles and operate mechanical equipment. If you experience nausea, dizziness, fatigue, or a headache while taking the pills, do not drive a car or operate any mechanical equipment, but call your doctor immediately.

How to use

Always take this medicine exactly as your doctor or pharmacist has recommended. If you have any doubts about taking this medicine, consult your doctor or pharmacist. The recommended starting dose of Norvasc is 5 mg once daily. The dose of Norvasc can be increased to 10 mg once a day. This medicine can be used both before and after meals and drinks. This medicine should be taken at the same time of day with water. Norvasc should not be taken with grapefruit juice. Use in children and adolescents As a rule, in children and adolescents (aged 6 to 17 years), the recommended starting dose of the drug is 2.5 mg per day. The maximum recommended dose of the drug is 5 mg per day. Norvasc 5 mg tablets can be divided into two halves to obtain a dose of 2.5 mg. It is important not to stop taking the drug. Don't wait until you run out of pills to go to the doctor. If you take more Norvasc tablets than you should. Taking too many tablets can cause your blood pressure to drop to dangerous levels. This may cause dizziness, a feeling of lightheadedness, weakness, or fainting. If blood pressure drops very sharply, shock can develop. The skin becomes cold and clammy and loss of consciousness may occur. If you take too many Norvasc tablets, seek medical help immediately. If you forget to take Norvasc, don't worry. If you forget to take a tablet, skip that dose of the drug completely. Take your next dose at the appropriate time. Do not take a double dose to make up for a missed dose. If you stop taking Norvasc, your doctor will tell you how long to take this medicine. If you stop taking this medicine earlier than recommended, your condition may return. If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

What side effects may occur

Like all medicines, Norvasc can cause side effects, but not all patients get them. Call your doctor immediately if you experience any of the following side effects after taking this medicine: • wheezing, chest pain, shortness of breath or difficulty breathing; • swelling of the eyelids, face or lips; • swelling of the tongue and pharynx, making breathing very difficult; • severe skin reactions, including severe skin rash, hives, redness of the entire body, severe itching, blistering, peeling and swelling of the skin, inflammation of the mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis) or other allergic reactions; • myocardial infarction, heart rhythm disturbance; • inflammation of the pancreas, which can manifest itself as severe pain in the abdomen and back, accompanied by a feeling of severe malaise. The following adverse event was reported very frequently. If this bothers you or lasts longer than one week, you should contact your doctor. Very common: may affect at least 1 in 10 people • swelling. The following side effects have been reported frequently. If they bother you or their duration exceeds one week, you should contact your doctor. Common (may occur in less than 1 person in 10) • headache, dizziness, drowsiness (especially at the beginning of treatment); • palpitations (sensation of heart contractions), hot flashes; • abdominal pain, feeling of nausea (nausea); • change in stool frequency, diarrhea, constipation, indigestion; • fatigue, weakness; • visual impairment, double vision; • muscle cramps; • swelling of the ankles. The following is a list of other reported adverse reactions. If any of these side effects become serious, or you notice side effects not listed in this leaflet, please tell your doctor or pharmacist. Uncommon (may affect less than 1 person in 100) • mood changes, anxiety, depression, insomnia; • trembling, taste disturbances, fainting; • numbness or tingling sensation in the limbs, loss of pain; • ringing in the ears; • low blood pressure; • sneezing/runny nose caused by inflammation of the nasal mucosa (rhinitis); • cough; • dry mouth, vomiting (feeling of nausea); • hair loss, increased sweating, itchy skin, red spots on the skin, change in skin color; • disturbance of urination, increased need to urinate at night, increased frequency of urination; • inability to achieve an erection, discomfort or enlargement of the mammary glands in men; • pain, poor health; • joint or muscle pain, back pain; • increase / decrease in body weight. Rare (may affect less than 1 in 1,000 people) • confusion. Very rare (may affect less than 1 in 10,000 people) • low white blood cell count, low platelet count, which may lead to unusual bruising or easy bleeding (damage to red blood cells); • increased blood glucose levels (hyperglycemia); • nerve damage, which may result in weakness, tingling or numbness; • swelling of the gums; • bloating (gastritis); • abnormal liver function, inflammation of the liver (hepatitis), yellow skin color (jaundice), increased activity of liver enzymes, which may affect the results of some medical tests; • increased muscle tension; • inflammation of blood vessels, often accompanied by skin rash; • sensitivity to sunlight; • disorders characterized by the simultaneous development of joint stiffness, trembling of the limbs and/or movement disorders.

Reporting Adverse Reactions

If you experience any unwanted reactions, consult your doctor. This recommendation applies to any possible adverse reactions, including those not listed in the package insert. You can also report adverse reactions to the Adverse Drug Events Information Database, including reports of drug failure. By reporting adverse reactions, you can help provide more information about the safety of the drug.

How to store

Keep this drug out of the reach of children. Do not use this drug after the expiration date, which is printed on the package after the word "EXP". The expiration date corresponds to the last day of the specified month. Store at a temperature not exceeding 25°C. Shelf life: 4 years. Medicines should not be disposed of in sewers or household waste. Ask your pharmacist for instructions on how to dispose of unused medicines. These measures will help protect the environment.

Compound

1 Norvasc 5 mg tablet contains 6.944 mg of amlodipine besylate, equivalent to 5 mg of amlodipine. 1 Norvasc 10 mg tablet contains 13.899 mg of amlodipine besylate, equivalent to 10 mg of amlodipine. Auxiliary components of the drug: microcrystalline cellulose (E460), anhydrous calcium hydrogen phosphate (E341), sodium starch glycolate (type A), magnesium stearate (E470). Appearance of the drug and contents of the package 5 mg tablets: white or almost white tablets in the shape of an emerald (octahedron with uneven sides) engraved “AML 5” and a score line on one side and the Pfizer logo on the other. or white or off-white emerald-shaped tablets (octagonal with uneven sides) engraved “AML 5” and scored on one side and unmarked on the other. 10 mg tablets: White or off-white emerald-shaped tablets (octagonal with jagged sides) embossed with "AML-10" on one side and the Pfizer logo on the other. or white or off-white emerald-shaped tablets (octagonal with uneven sides) engraved “AML-10” on one side and unmarked on the other. The 5 mg tablets can be divided into two equal halves. Tablets of 5 and 10 mg are available in 10 tablets in PVC or PVDC/aluminum blister packaging. 3 blisters along with instructions for use in a cardboard box.

Conditions for dispensing from pharmacies

Dispensed from pharmacies with a prescription.

Buy Norvasc tablet 5mg in bl. in pack No. 10x3 in the pharmacy

Price for Norvasc tablet 5 mg in bl. in pack №10x3

Instructions for use for Norvasc tablet 5 mg in bl. in pack №10x3

Drug interactions Norvasc

Norvasc is safe when used simultaneously with thiazide diuretics, α- and β-adrenergic blockers, ACE inhibitors, long-acting nitrates, sublingual nitroglycerin, NSAIDs, antibiotics and oral hypoglycemic drugs. The simultaneous use of Norvasc and digoxin in healthy volunteers did not change the level of the latter in the blood serum and its renal clearance, and the simultaneous use of cimetidine did not change the pharmacokinetics of amlodipine. in vitro studies using human blood plasma indicate that Norvasc does not affect the binding of drugs such as digoxin, phenytoin, warfarin and indomethacin to blood proteins. In healthy male volunteers, Norvasc, when used simultaneously, did not change the effect of warfarin on prothrombin time. According to pharmacokinetic studies, Norvasc did not significantly affect the pharmacokinetics of cyclosporine.

Norvasc, 10 mg, tablets, 14 pcs.

Amlodipine can be safely used for the treatment of arterial hypertension together with thiazide diuretics, α-blockers, β-blockers or ACE inhibitors. In patients with stable angina, amlodipine can be combined with other antianginal agents, such as long-acting or short-acting nitrates, beta-blockers.

Unlike other CCBs, a clinically significant interaction with amlodipine (III generation CCB) was not detected when used together with NSAIDs, incl. and with indomethacin.

It is possible to enhance the antianginal and hypotensive effect of CCBs when used together with thiazide and loop diuretics, ACE inhibitors, β-blockers and nitrates, as well as to enhance their hypotensive effect when used together with α1-blockers, antipsychotics.

Although negative inotropic effects have not generally been observed in amlodipine studies, some CCBs may potentiate the negative inotropic effects of antiarrhythmic drugs known to prolong the QT interval (eg, amiodarone and quinidine).

Amlodipine can also be safely used concomitantly with antibiotics and oral hypoglycemic agents.

A single dose of 100 mg of sildenafil in patients with essential hypertension does not affect the pharmacokinetic parameters of amlodipine.

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.

Simvastatin:

simultaneous repeated use of amlodipine at a dose of 10 mg and simvastatin at a dose of 80 mg leads to an increase in simvastatin exposure by 77%. In such cases, the dose of simvastatin should be limited to 20 mg.

Ethanol (beverages containing alcohol):

amlodipine with single and repeated use at a dose of 10 mg does not affect the pharmacokinetics of ethanol.

Antivirals (ritonavir):

increases plasma concentrations of BCC, incl. and amlodipine.

Neuroleptics and isoflurane:

enhancing the hypotensive effect of dihydropyridine derivatives.

Calcium preparations

may reduce the effect of CCBs.

When combined with CCBs and lithium preparations

(no data available for amlodipine), their neurotoxicity may increase (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).

Studies of the simultaneous use of amlodipine and cyclosporine in healthy volunteers and all groups of patients, with the exception of patients after kidney transplantation, have not been conducted. Various studies of the interaction of amlodipine with cyclosporine in patients after kidney transplantation show that the use of this combination may not lead to any effect or increase the Cmin of cyclosporine to varying degrees, up to 40%. These data should be taken into account and cyclosporine concentrations should be monitored in this group of patients when cyclosporine and amlodipine are co-administered.

Does not affect serum digoxin

and its renal clearance.

Does not significantly affect the action of warfarin

(PV).

Cimetidine:

does not affect the pharmacokinetics of amlodipine.

in vitro studies

of digoxin, phenytoin, warfarin and indomethacin
to plasma proteins Grapefruit juice:

A simultaneous single dose of 240 mg of grapefruit juice and 10 mg of amlodipine orally is not accompanied by a significant change in the pharmacokinetics of amlodipine. However, it is not recommended to use grapefruit juice and amlodipine at the same time, because with genetic polymorphism of the CYP3A4 isoenzyme, it is possible to increase the bioavailability of amlodipine and, as a result, increase the hypotensive effect.

Aluminum or magnesium containing antacids:

their single dose does not have a significant effect on the pharmacokinetics of amlodipine.

CYP3A4 isoenzyme inhibitors:

with simultaneous use of diltiazem at a dose of 180 mg and amlodipine at a dose of 5 mg in elderly patients (69 to 87 years old) with arterial hypertension, an increase in systemic exposure of amlodipine by 57% was observed. Concomitant use of amlodipine and erythromycin in healthy volunteers (18 to 43 years of age) does not lead to significant changes in amlodipine exposure (22% increase in AUC). Although the clinical significance of these effects is unclear, they may be more pronounced in older patients.

Potent inhibitors of the CYP3A4 isoenzyme (for example, ketoconazole, itraconazole) may increase the plasma concentration of amlodipine to a greater extent than diltiazem. Amlodipine and inhibitors of the CYP3A4 isoenzyme should be used with caution.

Clarithromycin:

CYP3A4 isoenzyme inhibitor. Patients taking clarithromycin and amlodipine at the same time have an increased risk of decreased blood pressure. Patients taking this combination are advised to be under close medical supervision.

Inducers of the CYP3A4 isoenzyme:

There is no data on the effect of inducers of the CYP3A4 isoenzyme on the pharmacokinetics of amlodipine. Blood pressure should be carefully monitored while using amlodipine and inducers of the CYP3A4 isoenzyme.

Tacrolimus:

When used simultaneously with amlodipine, there is a risk of increasing the concentration of tacrolimus in the blood plasma. To avoid toxicity of tacrolimus when used concomitantly with amlodipine, the concentration of tacrolimus in the blood plasma of patients should be monitored and the dose of tacrolimus should be adjusted if necessary.

Norvasc drug overdose, symptoms and treatment

Experience in treating Norvasc overdose in humans is limited. In some cases, gastric lavage is advisable. Existing data suggest that significant overdose may lead to excessive peripheral vasodilation with a subsequent marked and possibly prolonged decrease in blood pressure. Clinically significant arterial hypotension caused by an overdose of Norvasc requires active measures aimed at maintaining the function of the cardiovascular system, including monitoring of heart and lung parameters, elevated position of the lower extremities, control of circulating blood volume and diuresis. To restore vascular tone and normalize blood pressure, vasoconstrictor drugs can be used if there are no contraindications to their use. In order to eliminate the consequences of calcium channel blockade, intravenous administration of calcium gluconate solution is indicated. Since amlodipine is highly bound to plasma proteins, dialysis is ineffective.