Buy Norvasc Online

Norvasc (amlodipine besylate)

THERAPEUTIC CLASS

Calcium channel blocker (CCB) (dihydropyridine)

DEA CLASS

RX

INDICATIONS

Treatment of HTN, alone or in combination w/ other antihypertensive agents. Treatment of chronic stable angina or confirmed or suspected vasospastic (Prinzmetal's/variant) angina, alone or in combination w/ other antianginals. To reduce risk of hospitalization due to angina and the risk of coronary revascularization procedure in patients w/ recently documented coronary artery disease (CAD) by angiography and w/o heart failure or an ejection fraction <40%.

ADULT DOSAGE

Hypertension

Alone or in combination w/ 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

Angina

Chronic stable angina or confirmed or suspected vasospastic (Prinzmetal's/variant) angina, alone or in combination w/ 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 w/ recently documented coronary artery disease by angiography and w/o heart failure or an ejection fraction <40%

Usual: 5-10mg qd

PEDIATRIC DOSAGE

Hypertension

Alone or in combination w/ other antihypertensive agents

6-17 Years:
Usual: 2.5-5mg qd
Max: 5mg qd

DOSING CONSIDERATIONS

Concomitant Medications
HTN:
Other Antihypertensives:
2.5mg qd

Hepatic Impairment

HTN:
Initial:
2.5mg qd

Angina: Give lower dose

Elderly
HTN:
Initial: 2.5mg qd

Angina: Give lower dose

Other Important Considerations
HTN:
Small/Fragile Patients
:
Initial: 2.5mg qd

ADMINISTRATION

Oral route

HOW SUPPLIED

Tab: 2.5mg, 5mg, 10mg

WARNINGS/PRECAUTIONS

May cause symptomatic hypotension, particularly in patients w/ severe aortic stenosis. Worsening angina and acute MI may develop after starting or increasing the dose, particularly w/ severe obstructive CAD. Titrate slowly in patients w/ severe hepatic impairment.

ADVERSE REACTIONS

Edema, palpitations, dizziness, fatigue, flushing.

DRUG INTERACTIONS

Increased systemic exposure w/ 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 w/ CYP3A inducers. Monitor for hypotension when coadministered w/ 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.

PREGNANCY AND LACTATION

Category C, not for use in nursing.

MECHANISM OF ACTION

Calcium channel blocker (dihydropyridine); inhibits transmembrane influx of Ca2+ ions into vascular smooth muscle and cardiac muscle. Acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in BP.

PHARMACOKINETICS

Absorption: Absolute bioavailability (64-90%); Tmax=6-12 hrs. Distribution: Plasma protein binding (approx 93%). Metabolism: Hepatic (extensive). Elimination: Urine (10% unchanged, 60% metabolites); T1/2=30-50 hrs.

ASSESSMENT

Assess for hypersensitivity to the drug, severe aortic stenosis, severe obstructive CAD, hepatic impairment, pregnancy/nursing status, and possible drug interactions. Obtain baseline BP.

MONITORING

Monitor for worsening of angina, MI, and other adverse reactions. Monitor BP.

PATIENT COUNSELING

Inform of the risks/benefits of therapy. Advise to seek medical attention if any adverse effects develop. Instruct to take as prescribed.

STORAGE

15-30°C (59-86°F).

TAGS

norvasc buy online, norvasc 20 mg, norvasc online, norvasc patent, order norvasc, norvasc 5mg picture, norvasc for sale, norvasc 10mg amlodipine, norvasc 7.5 mg, norvasc 5 mg cheap, buy norvasc on line in united states, norvasc 5mg generic, norvasc tablets 5mg, norvasc mg, norvasc, buying norvasc, norvasc hctz, norvasc 7 mg, norvasc 5mg tablet, price of norvasc, norvasc brand name, buy cheap norvasc, norvasc coupons, norvasc amlodipine, order norvasc online, norvasc order, generic for norvasc, norvasc and hctz, norvasc generic equivalent, norvasc prices, norvasc coupon, purchase norvasc, norvasc 500 mg, sc norvasc to buy, norvasc without a prescription india, cheap norvasc online, non prescription norvasc, generic norvasc price, buy norvasc, norvasc purchase without prescription, norvasc cmi, norvasc generic, norvasc 10 mg, norvasc 100 mg, amlodipine norvasc, buy cheap pfizer norvasc, norvasc tablets, norvasc online no prescription, norvasc cost, cost of norvasc, norvasc tablet, cheap norvasc, norvasc without prescription, norvasc generic name, norvasc 5mg tab, buy norvasc online, diovan norvasc, norvasc 10mg buy, norvasc samples, 10 mg norvasc, generic of norvasc, norvasc 2 mg, levitra and norvasc, norvasc 50 mg, norvasc 5mg side effects, norvasc 2.5, norvasc 10mg side effects, generic norvasc, norvasc buy, online norvasc, norvasc 5mg price, norvasc canada, norvasc generic for sale, discount norvasc, norvasc 10mg, generic norvasc 10mg, norvasc pi, norvasc 2.5 mg, norvasc logo, norvasc cheap, norvasc 2 5mg, 10mg norvasc, norvasc no prescription, buy norvasc 5mg, norvasc 5, norvasc other names, buy norvasc no prescription, norvasc 2.5mg online in canada, norvasc 5mg, norvasc price