tizanidine, Zanaflex

Norvasc Moderate Interaction Moderate Interactions

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Norvasc Minor Interaction Minor Interactions

Accupril, Aceon, Alphagan, Alphagan P, Altace, apraclonidine ophthalmic, Aquacot, Aquatensen, Aquazide H, armodafinil, Atapryl, Azilect, benazepril, bendroflumethiazide, benzthiazide, brimonidine ophthalmic, Capoten, captopril, Carbex, Carozide, chlorothiazide, chlorthalidone, Cialis, Diaqua, Diucardin, Diurese, Diuril, Diuril Sodium, Eldepryl, Emsam, enalapril, enalaprilat, Enduron, Esidrix, Exna, Ezide, fluoxetine, fluoxetine extended release, fosinopril, furazolidone, Furoxone, HCTZ, Hydro Par, hydrochlorothiazide, HydroDIURIL, hydroflumethiazide, Hygroton, indapamide, Iopidine, isocarboxazid, Jumex, linezolid, lisinopril, Loqua, Lotensin, Lozol, Marplan, Matulane, Mavik, Metahydrin, methyclothiazide, metolazone, Microzide, modafinil, moexipril, Monopril, Mykrox, Naqua, Nardil, Naturetin-10, Naturetin-5, Nuvigil, Oretic, Parnate, perindopril, phenelzine, polythiazide, Prinivil, procarbazine, Provigil, Prozac, Prozac Weekly, quinapril, ramipril, Rapiflux, rasagiline, Renese, Saluron, Sarafem, selegiline, Selfemra, Selgene, tadalafil, Thalitone, trandolapril, tranylcypromine, trichlormethiazide, Univasc, Vasotec, verteporfin, Visudyne, Zaroxolyn, Zelapar, Zestril, zileuton, zileuton extended release, Zyflo, Zyflo CR, Zyvox

Buy Norvasc with FedEx overnight shipping and free prescription

Read this information carefully before you start Norvasc (NORE-vask) and each time you refill your prescription. There may be new information. This information does not replace talking with your doctor. If you have any questions about Norvasc, ask your doctor. Your doctor will know if Norvasc is right for you.

What is Norvasc?

Norvasc is a type of medicine known as a calcium channel blocker (CCB). It is used to treat high blood pressure (hypertension) and a type of chest pain called angina. It can be used by itself or with other medicines to treat these conditions.

High Blood Pressure (hypertension)
High blood pressure comes from blood pushing too hard against your blood vessels. Norvasc relaxes your blood vessels which lets your blood flow more easily and helps lower your blood pressure. Drugs that lower blood pressure lower your risk of having a stroke or heart attack.

Angina
Angina is a pain or discomfort that keeps coming back when part of your heart does not get enough blood. Angina feels like a pressing or squeezing pain, usually in your chest under the breastbone. Sometimes you can feel it in your shoulders, arms, neck, jaws, or back. Norvasc can relieve this pain.

Who should not use Norvasc?

Do not use Norvasc if you are allergic to amlodipine, (the active ingredient in Norvasc), or to the inactive ingredients. Your doctor or pharmacist can give you a list of these ingredients.

What should I tell my doctor before taking Norvasc?

Tell your doctor about any prescription and non-prescription medicines you are taking, including natural or herbal remedies.
Tell your doctor if you:

* ever had heart disease
* ever had liver problems
* are pregnant, or plan to become pregnant. Your doctor will decide if Norvasc is the best treatment for you.
* are breast-feeding. Do not breast feed while taking Norvasc. You can stop breastfeeding or take a different medicine.

How should I take Norvasc?

* Take Norvasc once a day, with or without food. You can take Norvasc with most drinks, including grapefruit juice.
* It may be easier to take your dose if you do it at the same time every day, such as with breakfast, dinner, or at bedtime. Do not take more than one dose of Norvasc at a time.
* If you miss a dose, take it as soon as you remember. Do not take Norvasc if it has been more than 12 hours since you missed your last dose. Wait and take the next dose at your regular time.
* Other medicines: You can use nitroglycerin and Norvasc together. If you take nitroglycerin for angina, don’t stop taking it while you are taking Norvasc.
* While you are taking Norvasc, do not stop taking your other prescription medicines, including any other blood pressure medicines, without talking to you doctor.
* If you took too much Norvasc, call your doctor or Poison Control Center, or go to the nearest hospital emergency room right away.

What should I avoid while taking Norvasc?

* Do not breastfeed. It is not known if Norvasc will pass through your milk.
* Do not start any new prescription or non-prescription medicines or supplements, unless you check with your doctor first.

What are the possible side effects of Norvasc?

Norvasc may cause the following side effects. Most side effects are mild or moderate:

* headache
* swelling of your legs or ankles
* tiredness, extreme sleepiness
* stomach pain, nausea
* dizziness
* flushing (hot or warm feeling in your face)
* arrhythmia (irregular heartbeat)
* heart palpitations (very fast heartbeat)

It is rare, but when you first start Norvasc or increase your dose, you may have a heart attack or your angina may get worse. If that happens, call your doctor right away or go directly to a hospital emergency room.

Tell your doctor if you are concerned about any side effects you experience. These are not all the possible side effects of Norvasc. For a complete list, ask your doctor or pharmacist.

How do I store Norvasc?

Keep Norvasc away from children. Store Norvasc tablets at room temperature (between 59 and 86 degrees Fahrenheit). Keep Norvasc out of the light. Do not store in the bathroom. Keep Norvasc in a dry place.

General advice about Norvasc

Sometimes, doctors will prescribe a medicine for a condition that is not written in the patient information leaflets. Only use Norvasc the way your doctor told you to. Do not give Norvasc to other people, even if they have the same symptoms you have. It may harm them.

You can ask your pharmacist or doctor for information about Norvasc, or you can visit the Pfizer website at www.pfizer.com or call 1-866-2 GOAL BP (1-866-246-2527).

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NDC 0069-1520-68          Bottle of 90

Norvasc–5 mg Tablets (amlodipine besylate equivalent to 5 mg of amlodipine per tablet) are white, elongated octagon, flat-faced, beveled edged engraved with both “Norvasc” and “5″ on one side and plain on the other side and supplied as follows:

NDC 0069-1530-68          Bottle of 90
NDC 0069-1530-41          Unit Dose package of 100
NDC 0069-1530-72          Bottle of 300

Norvasc–10 mg Tablets (amlodipine besylate equivalent to 10 mg of amlodipine per tablet) are white, round, flat-faced, beveled edged engraved with both “Norvasc” and “10″ on one side and plain on the other side and supplied as follows:

NDC 0069-1540-68          Bottle of 90
NDC 0069-1540-41          Unit Dose package of 100

Store bottles at controlled room temperature, 59° to 86°F (15° to 30°C) and dispense in tight, light-resistant containers (USP).

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The usual initial antihypertensive oral dose of Norvasc is 5 mg once daily with a maximum dose of 10 mg once daily. Small, fragile, or elderly individuals, or patients with hepatic insufficiency may be started on 2.5 mg once daily and this dose may be used when adding Norvasc to other antihypertensive therapy.

Dosage should be adjusted according to each patient’s need. In general, titration should proceed over 7 to 14 days so that the physician can fully assess the patient’s response to each dose level. Titration may proceed more rapidly, however, if clinically warranted, provided the patient is assessed frequently.

The recommended dose for chronic stable or vasospastic angina is 5–10 mg, with the lower dose suggested in the elderly and in patients with hepatic insufficiency. Most patients will require 10 mg for adequate effect.

The recommended dose range for patients with coronary artery disease is 5–10 mg once daily. In clinical studies the majority of patients required 10 mg.

Children

The effective antihypertensive oral dose in pediatric patients ages 6–17 years is 2.5 mg to 5 mg once daily. Doses in excess of 5 mg daily have not been studied in pediatric patients.

Co-administration with Other Antihypertensive and/or Antianginal Drugs

Norvasc has been safely administered with thiazides, ACE inhibitors, beta-blockers, long-acting nitrates, and/or sublingual nitroglycerin.

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Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia. In humans, experience with intentional overdosage of Norvasc is limited. Reports of intentional overdosage include a patient who ingested 250 mg and was asymptomatic and was not hospitalized; another (120 mg) was hospitalized, underwent gastric lavage and remained normotensive; the third (105 mg) was hospitalized and had hypotension (90/50 mmHg) which normalized following plasma expansion. A case of accidental drug overdose has been documented in a 19-month-old male who ingested 30 mg amlodipine (about 2 mg/kg). During the emergency room presentation, vital signs were stable with no evidence of hypotension, but a heart rate of 180 bpm. Ipecac was administered 3.5 hours after ingestion and on subsequent observation (overnight) no sequelae were noted.

If massive overdose should occur, active cardiac and respiratory monitoring should be instituted. Frequent blood pressure measurements are essential. Should hypotension occur, cardiovascular support including elevation of the extremities and the judicious administration of fluids should be initiated. If hypotension remains unresponsive to these conservative measures, administration of vasopressors (such as phenylephrine) should be considered with attention to circulating volume and urine output. Intravenous calcium gluconate may help to reverse the effects of calcium entry blockade. As Norvasc is highly protein bound, hemodialysis is not likely to be of benefit.

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Since the vasodilation induced by Norvasc is gradual in onset, acute hypotension has rarely been reported after oral administration. Nonetheless, caution, as with any other peripheral vasodilator, should be exercised when administering Norvasc, particularly in patients with severe aortic stenosis.

Naprosyn Beta-Blocker Withdrawal precautions

Norvasc is not a beta-blocker and therefore gives no protection against the dangers of abrupt beta-blocker withdrawal; any such withdrawal should be by gradual reduction of the dose of beta-blocker.

Drug/Laboratory Test Interactions

None known.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Rats and mice treated with amlodipine maleate in the diet for up to two years, at concentrations calculated to provide daily dosage levels of 0.5, 1.25, and 2.5 amlodipine mg/kg/day, showed no evidence of a carcinogenic effect of the drug. For the mouse, the highest dose was, on a mg/m2 basis, similar to the maximum recommended human dose of 10 mg amlodipine/day1. For the rat, the highest dose was, on a mg/m2 basis, about twice the maximum recommended human dose1.

Mutagenicity studies conducted with amlodipine maleate revealed no drug related effects at either the gene or chromosome level.

There was no effect on the fertility of rats treated orally with amlodipine maleate (males for 64 days and females for 14 days prior to mating) at doses up to 10 mg amlodipine/kg/day (8 times1 the maximum recommended human dose of 10 mg/day on a mg/m2 basis).

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Effect of other agents on Norvasc

CIMETIDINE

Co-administration of Norvasc with cimetidine did not alter the pharmacokinetics of Norvasc.

GRAPEFRUIT JUICE

Co-administration of 240 mL of grapefruit juice with a single oral dose of amlodipine 10 mg in 20 healthy volunteers had no significant effect on the pharmacokinetics of amlodipine.

MAALOX (antacid)

Co-administration of the antacid Maalox with a single dose of Norvasc had no significant effect on the pharmacokinetics of Norvasc.

SILDENAFIL

A single 100 mg dose of sildenafil (Viagra®) in subjects with essential hypertension had no effect on the pharmacokinetic parameters of Norvasc. When Norvasc and sildenafil were used in combination, each agent independently exerted its own blood pressure lowering effect.

Effect of Norvasc on other agents

ATORVASTATIN

Co-administration of multiple 10 mg doses of Norvasc with 80 mg of atorvastatin resulted in no significant change in the steady-state pharmacokinetic parameters of atorvastatin.

DIGOXIN

Co-administration of Norvasc with digoxin did not change serum digoxin levels or digoxin renal clearance in normal volunteers.

ETHANOL (alcohol)

Single and multiple 10 mg doses of Norvasc had no significant effect on the pharmacokinetics of ethanol.

WARFARIN

Co-administration of Norvasc with warfarin did not change the warfarin prothrombin response time.

In clinical trials, Norvasc has been safely administered with thiazide diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, long-acting nitrates, sublingual nitroglycerin, digoxin, warfarin, non-steroidal anti-inflammatory drugs, antibiotics, and oral hypoglycemic drugs.

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No evidence of teratogenicity or other embryo/fetal toxicity was found when pregnant rats and rabbits were treated orally with amlodipine maleate at doses up to 10 mg amlodipine/kg/day (respectively, 8 times1 and 23 times1 the maximum recommended human dose of 10 mg on a mg/m2 basis) during their respective periods of major organogenesis. However, litter size was significantly decreased (by about 50%) and the number of intrauterine deaths was significantly increased (about 5-fold) in rats receiving amlodipine maleate at a dose equivalent to 10 mg amlodipine/kg/day for 14 days before mating and throughout mating and gestation. Amlodipine maleate has been shown to prolong both the gestation period and the duration of labor in rats at this dose. There are no adequate and well-controlled studies in pregnant women. Amlodipine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

1: Based on patient weight of 50 kg.

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