Amlodipine should be used with caution in patients with hypotension, in patients whose cardiac reserve is poor and in those with heart failure since deterioration of heart failure has been noted. It should not be used in cardiogenic shock, in patients who have recently suffered a myocardial infarction or in acute unstable angina. It should not be used to treat an anginal attack in chronic stable angina. In patients with severe aortic stenosis it may increase the risk of developing heart failure. Sudden withdrawal might be associated with an exacerbation of angina. The dose may need to be reduced in patients with hepatic impairment. It should be discontinued in patients who experience ischemic pain following its administration.
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