In renal failure dose adjustment is required. Elderly patients, patients with a short, thin patients, patients with impaired liver function as a hypotensive agent, dianabol reviews administered in an initial dose of 2.5 mg, as anti-anginal agents – 5 mg.
Side effect On the part of the cardiovascular system: heart rate, shortness of breath, marked reduction in blood pressure, fainting, vasculitis, edema (swelling of the ankles and feet), “tides” of blood to the face, rarely – arrhythmias (bradycardia, ventricular tachycardia, atrial flutter) , chest pain, orthostatic hypotension, very rarely – the development or exacerbation of congestive heart failure, arrythmia, migraine.
On the part of the central nervous system: headache, dizziness, fatigue, drowsiness, mood changes, seizures, rare – loss of consciousness, hypoesthesia, nervousness , paraesthesia, tremor, vertigo, fatigue, malaise, insomnia, depression, abnormal dreams, very rarely – ataxia, apathy, agitation, amnesia. From the digestive system: nausea, vomiting, epigastric pain, rarely – increased level of “liver” transaminases and jaundice (caused by cholestasis), pancreatitis, dry mouth, flatulence, gingival hyperplasia, constipation or diarrhea, rarely – gastritis, increased appetite. From dianabol reviews the urogenital system: rare – pollakiuria, painful impulses pas urination, nocturia, sexual dysfunction ( including reduction of potency); very rarely – dysuria, polyuria. For the skin: very rarely – dermatoxerasia, alopecia, dermatitis, purpura, skin discoloration. Allergic reactions: itching, rash (including erythematous maculopapular rash, urticaria.), angioedema. With the musculoskeletal system: rarely – arthralgia, arthrosis, myalgia (with prolonged use); very rarely – myasthenia gravis. The other: seldom – gynecomastia, poliurikemiya, increase / decrease in body weight, thrombocytopenia, leukopenia, hyperglycemia, impaired vision, diplopia, conjunctivitis, eye pain, tinnitus, back pain, dyspnoea, epistaxis, increased sweating, thirst; very rarely – a cold clammy sweat, cough, rhinitis, parosmiya, taste disturbance, disturbance of accommodation, xerophthalmia.
Overdose Symptoms: marked reduction of blood pressure, tachycardia, excessive peripheral vasodilation. Treatment: gastric lavage, the appointment of activated carbon, the maintenance function of the cardiovascular system, the control performance of the heart and lungs, limbs elevated position, control of blood volume and diuresis. To restore vascular tone – use of vasopressors (in the absence of contraindications to their use); to eliminate the effects of calcium channel blockade – intravenous calcium gluconate. Hemodialysis is not effective.
Interaction with other drugs
inhibitors of microsomal oxidation increase the concentration of amlodipine in plasma, increasing the risk of side effects, and inducers of microsomal liver enzymes decrease.
Antihypertensive effect of dianabol reviews weakening non-steroidal anti-inflammatory drugs, especially indomethacin (sodium retention and synthesis of prostaglandins kidney blockade), Alpha adrenostimulyatorov , estrogens (sodium retention), sympathomimetic. Thiazide and “loop” diuretics, beta-blockers, verapamil, inhibitors and nitrates increase antianginal and antihypertensive effect. Amiodarone, quinidine, alpha 1-blockers, antipsychotic drugs (neuroleptics) and blockers “slow” calcium channels may increase the hypotensive effect.
It has no impact on the pharmacokinetic parameters of digoxin and warfarin. Cimetidine did not affect the pharmacokinetics of amlodipine.
In a joint application with drugs lithium may increase manifestations of neurotoxicity (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).
Calcium can reduce the effect of blockers “slow” calcium channels.
Procainamide, quinidine, and other drugs that cause QT interval prolongation, reinforce the negative inotropic effect and may increase the risk of significant lengthening QT interval.
grapefruit juice may reduce the concentration of amlodipine in the blood plasma, but this decrease is so small that it does not significantly alter the effect of amlodipine.
Can be used as monotherapy in most patients. At insufficient antihypertensive effect may be combined with ACE inhibitors, thiazide diuretics, alpha-blockers or beta-blockers.
Also be administered as monotherapy or in combination with other antianginal drugs in patients refractory to treatment with nitrates and / or beta-blockers in adequate doses.
during the period of treatment is necessary to control body weight and sodium intake, the appointment of an appropriate diet.
It is necessary to maintain dental hygiene and frequent visits to the dentist (to prevent soreness, bleeding and gingival hyperplasia). The dosage regimen for elderly patients is the same as for the patients in other age groups. By increasing the dose should be carefully monitored for elderly patients.
Despite the lack of blockers “slow” calcium channels syndrome “cancel” before the termination of treatment is recommended a gradual reduction in dose. Amlodipine has no effect on plasma concentrations of K + , glucose, triglycerides. total cholesterol, low density lipoprotein dianabol reviews cholesterol, uric acid, creatinine, uric acid and nitrogen.
Effects on ability to drive a car and mechanisms There were no reports on the effect of amlodipine on driving or using machinery. However, some patients, especially at the beginning of treatment, can occur drowsiness and dizziness. If this happens, the patient must take special precautions when driving and operating machinery.