Calcium channel blocker (CCB) (dihydropyridine)
Hypertension, Coronary Artery Disease, Angina
DOSAGE AND ADMINISTRATION:
Alone or in combination with other antihypertensive agents
Initial: 5mg qd
Titrate: Adjust according to BP goals
Wait 7-14 days between titration steps; if clinically warranted, titrate more rapidly and assess patient frequently
Max: 10mg qd
Chronic stable angina or confirmed or suspected vasospastic (Prinzmetal’s/variant) angina, alone or in combination with other antianginals
Usual: 5-10mg qd
Coronary Artery Disease:
Reduces the risk of hospitalization due to angina and reduces risk of coronary revascularization procedures in patients with recently documented coronary artery disease by angiography and w/o heart failure or an ejection fraction <40%
Usual: 5-10mg qd
Note: give the lowest dose (2.5 mg) in patients with hepatic impairment or elderly.
Usual: 2.5-5mg qd
Max: 5mg qd
PREGNANCY AND LACTATION
Category C, not for use in nursing.
WARNINGS AND PRECAUTIONS:
May cause symptomatic hypotension, particularly in patients with severe aortic stenosis.
Worsening angina and acute MI may develop after starting or increasing the dose, particularly with severe obstructive CAD.
Titrate slowly in patients with severe hepatic impairment.
Edema, palpitations, dizziness, fatigue, flushing.
Increased systemic exposure with moderate and strong CYP3A inhibitors and may require dose reduction; monitor for symptoms of hypotension and edema to determine the need for dose adjustment.
Closely monitor BP if coadministered with CYP3A inducers.
Monitor for hypotension when coadministered with sildenafil.
May increase simvastatin exposure; limit dose of simvastatin to 20mg daily.
May increase systemic exposure of cyclosporine or tacrolimus; monitor trough blood levels of cyclosporine and tacrolimus frequently and adjust dose when appropriate.
Store below 30°C .
Keep out of reach of children.