Adult: As monotherapy or in combination with other antihypertensive agents: Usual initial dose: 2.5 mg once daily. In patients already on other antihypertensive therapy, a lower initial dose of 1.25 mg once daily may be used. Titrate dose every 1-2 weeks according to blood pressure goals and patient response. Max: 5 mg once daily. Elderly: As monotherapy or in combination with other antihypertensive agents: Initially, 1.25 mg once daily. Titrate dose every 1-2 weeks according to blood pressure goals and patient response. Child: 6-17 years As monotherapy or in combination with other antihypertensive agents: 1.25-2.5 mg once daily.
What are the brands available for Levamlodipine in Philippines?
Debilitated patients: Initially, 1.25 mg once daily. Titrate dose every 1-2 weeks according to blood pressure goals and patient response.
Hepatic Impairment
Initially, 1.25 mg once daily. Titrate dose slowly in patients with severe impairment.
Administration
Levamlodipine May be taken with or without food. Levamlodipine malate May be taken with or without food.
Special Precautions
Patient with severe aortic stenosis, hypertrophic cardiomyopathy and left ventricular outflow tract obstruction. Debilitated patients. Hepatic impairment. Children and elderly. Pregnancy and lactation.
Adverse Reactions
Significant: Symptomatic hypotension; worsening angina and acute MI (particularly in patients with severe obstructive CAD). Cardiac disorders: Palpitations. Gastrointestinal disorders: Nausea, abdominal pain. General disorders and administration site conditions: Fatigue, oedema. Nervous system disorders: Dizziness, somnolence. Vascular disorders: Flushing.
Monitoring Parameters
Monitor blood pressure and heart rate.
Overdosage
Symptoms: Peripheral vasodilation with marked hypotension and possibly reflex tachycardia. Management: Start active cardiac and respiratory monitoring. Monitor blood pressure frequently. In case of hypotension, provide CV support, including elevation of extremities and administration of fluids. If hypotension remains unresponsive to such measures, consider administration of vasopressors (e.g. phenylephrine) while monitoring circulating volume and urine output.
Drug Interactions
Increased systemic exposure with moderate and strong CYP3A inhibitors. May increase the serum concentrations of simvastatin, ciclosporin and tacrolimus.
Lab Interference
May cause a false-negative aldosterone/renin ratio.
Action
Description: Mechanism of Action: Levamlodipine is the pharmacologically active isomer of amlodipine, a dihydropyridine Ca channel blocker. Amlodipine inhibits Ca ion transmembrane influx into vascular smooth muscles and, to a lesser extent, cardiac muscle cells. It acts directly on vascular smooth muscle, leading to a decrease in peripheral vascular resistance and a reduction in blood pressure. Synonym(s): S-amlodipine. Onset: Gradual. Duration: ≥24 hours. Pharmacokinetics: Absorption: Bioavailability: 64-90%. Time to peak plasma concentration: 6-12 hours. Distribution: Plasma protein binding: Approx 93%. Metabolism: Extensively metabolised in the liver (approx 90%) to form inactive metabolites. Excretion: Via urine (60% as metabolites, 10% as unchanged drug). Terminal elimination half-life: Approx 30-50 hours.
Chemical Structure
Levamlodipine Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 9822750, Levamlodipine. https://pubchem.ncbi.nlm.nih.gov/compound/Levamlodipine. Accessed Nov. 25, 2024.
C08CA17 - levamlodipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
References
Anon. Levamlodipine Maleate. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 05/11/2024.Brayfield A, Cadart C (eds). Levamlodipine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/11/2024.Conjupri Tablet (CSPC Ouyi Pharmaceutical Co. Ltd). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/11/2024.Levamlodipine. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 05/11/2024.Levamlodipine. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 05/11/2024.
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