Uses of Aripen: - Hypertension (high blood pressure) - Angina (heart-related chest pain) Oral Prinzmetal's angina; Stable angina Adult: Initially, 5 mg once daily increased to 10 mg once daily if necessary. Elderly: Initially, 2.5 mg once daily. maintenance: 10 mg/day Hepatic impairment: Initially, 2.5 mg once daily. Hypertension Adult: Initially, 5 mg once daily increased to 10 mg once daily if necessary. Elderly: Initially, 2.5 mg once daily. may be increased by 2.5 mg/day every 7-14 days; not to exceed 10 mg/day PO; maintenance: 5-10 mg/day PO Hepatic impairment: Initially, 2.5 mg once daily. Hypertension <6 years: Safety and efficacy not established >6 years: 2.5-5 mg/day PO

Calcium-channel blockers

Amlodipine is a long-acting calcium channel blocker that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Thus it causes reduction in peripheral vascular resistance and contractile process in cardiac muscle and reduces blood pressure.The mechanism of the antihypertensive action is due to a direct relaxant effect on vascular smooth muscle. The precise mechanism by which amlodipine relieves angina has not been fully determined but Amlodipine reduces total ischemic burden by the following two actions: Amlodipine dilates peripheral arterioles and thus, reduces the total peripheral resistance (after load) against which the heart works. Since the heart rate remains stable, this unloading of the heart reduces myocardial energy consumption and oxygen requirements. The mechanism of action of Amlodipine also probably involves dilatation of the main coronary arteries and coronary arterioles, both in normal and ischemic regions. This dilation increases myocardial oxygen delivery in patients with coronary artery spasm (prinzmetals or variant angina).

How to use Amlodipine: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Amlodipine may be taken with or without food, but it is better to take it at a fixed time. Administration: Plasma concentrations may be elevated w/ CYP3A4 inhibitors (e.g. azole antifungals, ritonavir). Concomitant therapy w/ simvastatin may increase risk of myopathy including rhabdomyolysis. May increase ciclosporin plasma levels and conivaptan. Adult Dose: Impaired liver or renal function, CHF, sick-sinus syndrome, severe ventricular dysfunction, hypertrophic cardiomyopathy, severe aortic stenosis. Caution when used in patients with idiopathic hypertrophic subaortic stenosis. Elderly, children. Pregnancy, lactation. Use in renal failure: Although Amlodipine is excreted primarily via kidney, mild renal impairment does not appear to have an effect on the plasma concentrations. Severe renal impairment may however require a dosage reduction. Amlodipine is not dialyzable. Use in patients with impaired hepatic function: Amlodipine half-life is prolonged in patient with impaired hepatic function. Amlodipine should therefore be administered at lower (5mg) initial dose in these patients. Use in heart failure: An increased number of pulmonary oedema has been reported. Lactation: Unknown whether drug is excreted in milk; use not recommended Renal Dose: Amlodipine relaxes peripheral and coronary vascular smooth muscle. It produces coronary vasodilation by inhibiting the entry of Ca ions into the slow channels or select voltage-sensitive channels of the vascular smooth muscle and myocardium during depolarisation. It also increases myocardial oxygen delivery in patients w/ vasospastic angina.

Hypersensitivity to Amlodipine or other calcium channel antagonist, Severe hypertension.

Hypertension <6 years: Safety and efficacy not established >6 years: 2.5-5 mg/day PO

Common - Fatigue - Ankle swelling - Sleepiness - Flushing (sense of warmth in the face, ears, neck and trunk) - Headache - Nausea - Dizziness - Palpitations - Edema (swelling) - Abdominal pain

Pregnancy Category C. There are no adequate and well-controlled studies of Amlodipine in pregnant women. Amlodipine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Amlodipine is excreted in human milk. In the absence of this information, it is recommended that nursing be discontinued while Amlodipine is administered.

Precaution: Mild to moderate hypertension, Chronic stable and vasospastic angina, Raynaud's disease, Coronary Artery Disease, HTN, Stroke prevention

In humans, experience with intentional overdose is limited.Symptoms: Available data suggest that large overdosage could result in excessive peripheral vasodilatation and possibly reflex tachycardia. Marked and probably prolonged systemic hypotension up to and including shock with fatal outcome have been reported.Management: Clinically significant hypotension due to amlodipine overdosage calls for active cardiovascular support including frequent monitoring of cardiac and respiratory function, elevation of extremities, and attention to circulating fluid volume and urine output. A vasoconstrictor may be helpful in restoring vascular tone and blood pressure, provided that there is no contraindication to its use. Intravenous calcium gluconate may be beneficial in reversing the effects of calcium channel blockade. Gastric lavage may be worthwhile in some cases. In healthy volunteers the use of charcoal up to 2 hours after administration of amlodipine 10 mg has been shown to reduce the absorption rate of amlodipine. Since amlodipine is highly protein-bound, dialysis is not likely to be of benefit.

keep in a dry place away from light and heat. Keep out of the reach of children.

May be taken with or without food.

>10% Edema (1.8-10.8%),Pulmonary edema (7-15%) 1-10% Headache (7.3%),Fatigue (4.5%),Palpitations (0.7-4.5%),Dizziness (1.1-3.4%),Nausea (2.9%),Flushing (0.7-2.6%),Abdominal pain (1.6%),Somnolence (1.4%),Male sexual disorder (1-2%),Drowsiness (1%),Pruritus (1-2%),Skin rash (1-2%),Muscle cramps (1-2%),Muscle weakness (1-2%) Potentially Fatal: Hypotension, bradycardia, conductive system delay and CCF.