Amlodipine and atorvastatin

Name: Amlodipine and atorvastatin

What should I discuss with my healthcare provider before taking amlodipine and atorvastatin?

You should not use this medicine if you are allergic to amlodipine (Norvasc) or atorvastatin (Lipitor), or if:

  • you have liver disease; or

  • you are pregnant or breast-feeding.

Do not use amlodipine and atorvastatin if you are pregnant. It could harm the unborn baby or cause birth defects. Use effective birth control to prevent pregnancy while you are using this medicine. If you become pregnancy, stop taking this medicine and tell your doctor right away.

It is not known whether amlodipine and atorvastatin passes into breast milk or if it could harm a nursing baby. Do not breast-feed while taking amlodipine and atorvastatin.

To make sure amlodipine and atorvastatin is safe for you, tell your doctor if you have ever had:

  • liver disease;

  • kidney disease;

  • heart disease;

  • diabetes;

  • a thyroid disorder; or

  • if you drink more than 2 alcoholic beverages daily.

Atorvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. This condition may be more likely to occur in older adults and in people who have kidney disease or poorly controlled hypothyroidism (underactive thyroid).

Certain other drugs can increase your risk of serious muscle problems when used with amlodipine and atorvastatin. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • colchicine;

  • cyclosporine;

  • medicines that contain niacin (Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others);

  • an antibiotic--clarithromycin, erythromycin;

  • antifungal medicine--itraconazole, ketoconazole, voriconazole;

  • certain cholesterol medications--gemfibrozil, fenofibric acid, fenofibrate; or

  • antiviral medicine to treat hepatitis C or HIV/AIDS--boceprevir, darunavir, fosamprenavir, lopinavir, nelfinavir, ritonavir, saquinavir, telaprevir, tipranavir.

What should I avoid while taking amlodipine and atorvastatin?

Avoid eating foods that are high in fat or cholesterol. This medication will not be as effective in treating your condition if you do not follow the diet plan recommended by your doctor.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage. Alcohol can also further lower blood pressure and can increase some of the side effects of amlodipine and atorvastatin.

Grapefruit and grapefruit juice may interact with atorvastatin and lead to potentially dangerous effects. Avoid the use of grapefruit products while taking amlodipine and atorvastatin.

Commonly used brand name(s)

In the U.S.

  • Caduet

Available Dosage Forms:

  • Tablet

Therapeutic Class: Calcium Channel Blocker/HMG-COA Reductase Inhibitor Combination

Pharmacologic Class: Amlodipine

Chemical Class: Amlodipine

Uses For amlodipine and atorvastatin

Amlodipine and atorvastatin is a combination of a calcium channel blocker and HMG-CoA reductase inhibitor (statin). Amlodipine is used alone or together with other medicines to treat angina (chest pain) or high blood pressure. High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Maintaining a lower blood pressure can reduce the risk of strokes and heart attacks.

Atorvastatin is used together with a proper diet to lower cholesterol and triglyceride (fats) levels in the blood. amlodipine and atorvastatin may help prevent medical problems (e.g., chest pain, heart attack, or stroke) that are caused by fats clogging the blood vessels. It may also be used to prevent certain types of heart and blood vessel problems in patients with risk factors for heart problems.

amlodipine and atorvastatin is available only with your doctor's prescription.

Precautions While Using amlodipine and atorvastatin

It is important that your doctor check your progress at regular visits. This will allow your doctor to make sure the medicine is working properly to lower your cholesterol and triglyceride levels and blood pressure, and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

Using amlodipine and atorvastatin while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness. These could be symptoms of serious muscle problems, such as myopathy or immune-mediated necrotizing myopathy (IMNM).

Call your doctor right away if you have dark-colored urine, fever, muscle cramps or spasms, muscle pain or stiffness, or unusual tiredness or weakness. These could be symptoms of a serious muscle problem called rhabdomyolysis, which can cause kidney problems.

Make sure any doctor or dentist who treats you knows that you are using amlodipine and atorvastatin. You may need to stop using amlodipine and atorvastatin if you have a major surgery or injury.

Dizziness, lightheadedness, or fainting may also occur if you exercise or if the weather is hot. Heavy sweating can cause loss of too much water and result in low blood pressure. Use extra care during exercise or hot weather.

amlodipine and atorvastatin may worsen the symptoms of angina (chest pain) or increase risk of heart attack in certain patients with severe heart or blood vessel disease. Check with your doctor right away if you have chest pain that is worse than usual, trouble breathing, nausea or vomiting, pain or discomfort in your arms, jaw, back, or neck, feel faint, or you are sweating.

If you have been using amlodipine and atorvastatin regularly for several weeks, do not suddenly stop using it. Stopping suddenly may cause your chest pain or high blood pressure to come back or get worse. Check with your doctor for the best way to reduce gradually the amount you are taking before stopping completely.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What do I need to tell my doctor BEFORE I take Amlodipine and Atorvastatin?

  • If you have an allergy to amlodipine, atorvastatin, or any other part of amlodipine and atorvastatin.
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you have any of these health problems: Active liver disease or a rise in liver enzymes.
  • If you are pregnant or may be pregnant. Do not take this medicine if you are pregnant.
  • If you are breast-feeding. Do not breast-feed while you take amlodipine and atorvastatin.
  • If you are taking any of these drugs: Cyclosporine, gemfibrozil, telaprevir, or tipranavir plus ritonavir.
  • If you are taking any of these drugs: Cimetidine, ketoconazole, or spironolactone.

This is not a list of all drugs or health problems that interact with this medicine.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take amlodipine and atorvastatin with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

Dosing Renal Impairment

No dosage adjustment is necessary.

Administration

May be administered without regard to meals.

Usual Adult Dose for Prevention of Cardiovascular Disease

Initial dose: Amlodipine 5 mg-Atorvastatin 10 to 20 mg orally once a day

Maximum dose: Amlodipine 10 mg-Atorvastatin 80 mg orally once a day

Comments:
-Small adult, fragile, or elderly patients may be started on amlodipine 2.5 mg orally once a day.
-Most coronary artery disease patients will require amlodipine 10 mg orally once a day for adequate effect.
-Patients who require greater than 45% low-density lipoprotein (LDL) reduction may be started on atorvastatin 40 mg orally once a day.
-May be titrated for amlodipine after 1 to 2 weeks and for atorvastatin after 2 to 4 weeks.
-Atorvastatin has not been studied in conditions where the major lipoprotein abnormality is elevation of chylomicrons (Fredrickson types I and V).

Renal Dose Adjustments

No adjustment recommended

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