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amlodipine and atorvastatin (Oral route)

am-LOE-di-peen BES-i-late, a-tor-va-STAT-in KAL-see-um

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.

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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.

Before Using amlodipine and atorvastatin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For amlodipine and atorvastatin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to amlodipine and atorvastatin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of amlodipine and atorvastatin combination in the pediatric population. Safety and efficacy have not been established.

Appropriate studies have not been performed on the relationship of age to the effects of amlodipine to treat high blood pressure in children younger than 6 years of age. Safety and efficacy have not been established.

Atorvastatin alone is safe to use in boys and some girls 10 to 17 years of age for treating certain types of high cholesterol.

Teenage girls taking atorvastatin should be counseled on appropriate birth control methods to prevent pregnancy.

Geriatric

Appropriate studies have not been performed on the relationship of age to the effects of amlodipine and atorvastatin combination in the geriatric population. Safety and efficacy have not been established.

Pregnancy

Pregnancy Category Explanation
All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking amlodipine and atorvastatin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using amlodipine and atorvastatin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Posaconazole

Using amlodipine and atorvastatin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amiodarone
  • Atazanavir
  • Bezafibrate
  • Ciprofibrate
  • Clarithromycin
  • Clofibrate
  • Clopidogrel
  • Cobicistat
  • Colchicine
  • Conivaptan
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Dalfopristin
  • Danazol
  • Dantrolene
  • Daptomycin
  • Darunavir
  • Diltiazem
  • Domperidone
  • Droperidol
  • Erlotinib
  • Erythromycin
  • Eslicarbazepine Acetate
  • Fenofibrate
  • Fenofibric Acid
  • Fentanyl
  • Fluconazole
  • Fosamprenavir
  • Fusidic Acid
  • Gemfibrozil
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Lopinavir
  • Mibefradil
  • Mitotane
  • Nefazodone
  • Nelfinavir
  • Niacin
  • Piperaquine
  • Primidone
  • Quinupristin
  • Saquinavir
  • Simeprevir
  • Simvastatin
  • St John's Wort
  • Tegafur
  • Telaprevir
  • Telithromycin
  • Tipranavir
  • Troleandomycin
  • Verapamil

Using amlodipine and atorvastatin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Aceclofenac
  • Acemetacin
  • Alprenolol
  • Amiodarone
  • Amprenavir
  • Amtolmetin Guacil
  • Aspirin
  • Atenolol
  • Avanafil
  • Azithromycin
  • Betaxolol
  • Bevantolol
  • Bexarotene
  • Bisoprolol
  • Black Cohosh
  • Boceprevir
  • Bosentan
  • Bromfenac
  • Bucindolol
  • Bufexamac
  • Carteolol
  • Carvedilol
  • Celecoxib
  • Celiprolol
  • Choline Salicylate
  • Clonixin
  • Clopidogrel
  • Dalfopristin
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Digoxin
  • Dilevalol
  • Diltiazem
  • Dipyrone
  • Efavirenz
  • Eltrombopag
  • Esmolol
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Etravirine
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Fluconazole
  • Flufenamic Acid
  • Flurbiprofen
  • Fosphenytoin
  • Ibuprofen
  • Ibuprofen Lysine
  • Imatinib
  • Indinavir
  • Indomethacin
  • Interferon Beta
  • Itraconazole
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Labetalol
  • Levobunolol
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Mepindolol
  • Metipranolol
  • Metoprolol
  • Morniflumate
  • Nabumetone
  • Nadolol
  • Naproxen
  • Nebivolol
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Oat Bran
  • Oxaprozin
  • Oxprenolol
  • Oxyphenbutazone
  • Parecoxib
  • Pectin
  • Penbutolol
  • Phenylbutazone
  • Phenytoin
  • Piketoprofen
  • Pindolol
  • Pioglitazone
  • Piroxicam
  • Pranoprofen
  • Proglumetacin
  • Propranolol
  • Propyphenazone
  • Proquazone
  • Quinine
  • Quinupristin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sotalol
  • St John's Wort
  • Sulindac
  • Talinolol
  • Tenoxicam
  • Tertatolol
  • Tiaprofenic Acid
  • Timolol
  • Tolfenamic Acid
  • Tolmetin
  • Valdecoxib
  • Voriconazole

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using amlodipine and atorvastatin with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use amlodipine and atorvastatin, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of amlodipine and atorvastatin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, or history of or
  • Liver disease, history of—Use with caution. May cause side effects to become worse.
  • Convulsions (seizures), not well-controlled or
  • Electrolyte or metabolic enzyme deficiencies or disorders or
  • Hypotension (low blood pressure) or
  • Infection, severe or
  • Kidney disease, severe or
  • Major surgery or trauma, recent—Patients with these conditions may be at risk of developing muscle and kidney problems.
  • Coronary artery disease, severe, obstructive—Use of amlodipine and atorvastatin may result in other heart problems.
  • Diabetes or
  • Thyroid problems—Use with caution. May make these conditions worse.
  • Heart disease (e.g., aortic stenosis)—Use with caution. The blood pressure-lowering effects of amlodipine and atorvastatin may be increased.
  • Liver disease, active or
  • Liver enzymes, elevated—Should not be used in patients with these conditions.
  • Stroke, recent or
  • Transient ischemic attack (TIA), recent—Atorvastatin may increase chance of having hemorrhagic stroke (stroke caused by bleeding in the brain).

Proper Use of amlodipine and atorvastatin

Use amlodipine and atorvastatin only as directed by your doctor even if you feel well and do not notice any chest pain. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

amlodipine and atorvastatin comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

In addition to the use of the medicine, treatment for your high blood pressure may include weight control and a change in the types of food you eat, especially foods high in sodium (salt). Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that amlodipine and atorvastatin will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Swallow the tablet whole. Do not break, crush, or chew it. Take amlodipine and atorvastatin with or without food.

amlodipine and atorvastatin works best if there is a constant amount in the blood. To help keep this amount constant, do not miss any doses and take the medicine at the same time each day.

In addition to amlodipine and atorvastatin, your doctor may change your diet to one that is low in fat, sugar, and cholesterol. Carefully follow your doctor's orders about any special diet.

Do not drink large amounts of alcohol with atorvastatin. This could cause unwanted effects on the liver.

Tell your doctor if you drink grapefruit juice. Drinking large amounts of grapefruit juice (more than 1.2 liters each day) while taking amlodipine and atorvastatin may increase your risk of muscle injury and could result in kidney problems.

Dosing

The dose of amlodipine and atorvastatin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of amlodipine and atorvastatin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • Adults—1 tablet once a day, tablet strength is determined by your doctor depending on your condition.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of amlodipine and atorvastatin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Do not take amlodipine and atorvastatin if it has been more than 12 hours since you missed your last dose.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

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.

amlodipine and atorvastatin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Cough
  • difficulty with swallowing
  • dizziness
  • fast heartbeat
  • hives
  • itching
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • skin rash
  • tightness in the chest
  • unusual tiredness or weakness
  • wheezing
Rare
  • Chest pain or discomfort
  • dilated neck veins
  • extra heartbeats
  • extreme fatigue
  • irregular breathing
  • irregular heartbeat
  • pulse irregularity
  • swelling of the face, fingers, feet, or lower legs
  • weight gain
Incidence not known
  • Blistering, peeling, or loosening of the skin
  • chills
  • dark-colored urine
  • diarrhea
  • fever
  • joint or muscle pain
  • muscle cramps or spasms
  • muscle stiffness
  • red, irritated eyes
  • red skin lesions, often with a purple center
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Blurred vision
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • feeling of warmth
  • redness of the face, neck, arms, and occasionally, upper chest
  • sweating

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Body aches or pain
  • congestion
  • difficulty with moving
  • headache
  • lower back or side pain
  • pain or tenderness around the eyes and cheekbones
  • painful or difficult urination
  • runny or stuffy nose
  • tender, swollen glands in the neck
  • voice changes
Less common
  • Accidental injury
  • acid or sour stomach
  • belching
  • bloated or full feeling
  • difficulty having a bowel movement (stool)
  • excess air or gas in the stomach or intestines
  • general feeling of discomfort or illness
  • heartburn
  • indigestion
  • lack or loss of strength
  • loss of appetite
  • nausea
  • passing gas
  • shivering
  • sleepiness or unusual drowsiness
  • stomach discomfort, upset, or pain
  • trouble sleeping
  • vomiting
Rare
  • Anxiety
  • bad, unusual, or unpleasant (after) taste
  • blistering, crusting, irritation, itching, or reddening of the skin
  • burning feeling in the chest or stomach
  • burning while urinating
  • change in near or distance vision
  • change in taste
  • change in the color of the skin
  • cold and clammy skin
  • cracked, dry, scaly skin
  • difficulty in focusing eyes
  • dry mouth
  • dryness of the eyes
  • excessive muscle tone
  • frequent urination
  • hair loss or thinning of the hair
  • increased appetite
  • increased volume of pale, dilute urine
  • irritability
  • lack of feeling or emotion
  • loose stools
  • loss of memory
  • muscle tension or tightness
  • muscle weakness
  • problems with memory
  • restlessness
  • severe and throbbing headache
  • shakiness and unsteady walk
  • sneezing
  • tenderness in the stomach area
  • transient, mild, or pleasant aromatic odor
  • trembling, or other problems with muscle control or coordination
  • twitching
  • uncaring
  • unsteadiness
  • welts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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