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amlodipine and atorvastatin

Generic Name: amlodipine and atorvastatin (am LOE di peen and a TOR va sta tin)
Brand Name: Caduet

What is amlodipine and atorvastatin?

Atorvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins." Atorvastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).

Amlodipine is a calcium channel blocker. Amlodipine relaxes the blood vessels, improving blood flow and making it easier for the heart to pump.

Amlodipine and atorvastatin is a combination medicine used to treat high blood pressure (hypertension) or chest pain (angina), and to lower the risk of stroke, heart attack, and other heart complications in people with type 2 diabetes, coronary heart disease, or other risk factors.

Amlodipine and atorvastatin is used in adults and children who are at least 10 years old.

Amlodipine and atorvastatin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amlodipine and atorvastatin?

You should not use this medicine if you have liver disease.

Amlodipine and atorvastatin can harm an unborn baby or cause birth defects. Do not use if you are pregnant.

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You should not use this medicine if you are breast-feeding a baby.

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

  • if you are pregnant or breast-feeding.

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

  • a history of liver or kidney disease;

  • heart disease;

  • diabetes;

  • muscle pain or weakness;

  • 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).

Tell your doctor about all other medications you use. Certain other drugs can increase your risk of serious muscle problems, and it is very important that your doctor knows if you are using any of them:

  • 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.

This medicine can harm an unborn baby or cause birth defects. Do not use if you are pregnant. Use effective birth control to prevent pregnancy, and tell your doctor right away if you become pregnant.

It is not known whether amlodipine and atorvastatin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take amlodipine and atorvastatin?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Amlodipine and atorvastatin is usually taken once a day, with or without food. Take the medicine at the same time each day.

Do not break an amlodipine and atorvastatin tablet. Tell your doctor if you have trouble swallowing the pill.

You may need to stop using amlodipine and atorvastatin for a short time if you have:

  • uncontrolled seizures;

  • an electrolyte imbalance (such as high or low potassium levels in your blood);

  • severely low blood pressure;

  • a severe infection or illness; or

  • surgery or a medical emergency.

While using amlodipine and atorvastatin, you may need frequent blood tests. Your kidney function may also need to be checked.

Amlodipine and atorvastatin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

You may need to take amlodipine and atorvastatin on a long-term basis for the treatment of high cholesterol. If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if your next dose is less than 12 hours away. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

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.

Amlodipine and atorvastatin side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, atorvastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

Stop using amlodipine and atorvastatin and call your doctor at once if you have:

  • muscle stiffness, tremors, abnormal muscle movements;

  • severe drowsiness, feeling like you might pass out;

  • worsening chest pain, or chest pain spreading to the arm or jaw, nausea, sweating, general ill feeling; or

  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • muscle or joint pain;

  • diarrhea;

  • nausea, upset stomach; or

  • swelling in your legs or ankles.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amlodipine and atorvastatin dosing information

Usual Adult Dose for Hyperlipidemia:

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).

Usual Adult Dose for Hypertension:

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).

Usual Adult Dose for Angina Pectoris:

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).

Usual Adult Dose for Coronary Artery 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).

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).

What other drugs will affect amlodipine and atorvastatin?

Many drugs can interact with amlodpine and atorvastatin. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • sildenafil (Viagra);

  • birth control pills;

  • an antibiotic or antifungal medicine;

  • heart medication;

  • medicine to prevent organ transplant rejection; or

  • any other "statin" medication--atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin.

This list is not complete and many other drugs can interact with amlodipine and atorvastatin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about amlodipine and atorvastatin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.01. Revision Date: 2015-06-26, 8:39:37 AM.

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