Norvasc 5mg 30 Tablets

Active Ingredient: Amlodipine Coronary artery disease (CAD): Chronic stable angina: Treatment of symptomatic chronic stable angina. May be used alone or in combination with other antianginal agents. Vasospastic angina (Prinzmetal or variant angina): Treatment of confirmed or suspected vasospastic angina. May be used alone or in combination with other antianginal agents. Angiographically documented CAD: Reduce the risk of hospitalization secondary to angina and to reduce the risk of a coronary revascularization procedure in patients with recently documented CAD by angiography (without heart failure or an ejection fraction of <40%). The ACCF/AHA 2013 guidelines for management of heart failure state that, with the exception of amlodipine, calcium channel blockers should be avoided and withdrawn whenever possible in patients with heart failure with reduced ejection fraction (HFrEF). While amlodipine, like other calcium channel blockers, has no benefit on functioning or survival, it may be used for the treatment of hypertension or ischemic heart disease in patients with HFrEF (ACCF/AHA [Yancy 2013]). Hypertension: Treatment of hypertension. May be used alone or in combination with other antihypertensive agents. Guideline recommendations: The 2014 guideline for the management of high blood pressure in adults (JNC 8) recommends initiation of pharmacologic treatment to lower blood pressure for the following patients (JNC8 [James 2013]): • Patients ≥60 years, with systolic blood pressure (SBP) ≥150 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg. • Patients <60 years, with SBP ≥140 mm Hg or DBP ≥90 mm Hg. • Patients ≥18 years with diabetes, with SBP ≥140 mm Hg or DBP ≥90 mm Hg. • Patients ≥18 years with chronic kidney disease (CKD), with SBP ≥140 mm Hg or DBP ≥90 mm Hg. Chronic kidney disease (CKD) and hypertension: In patients with chronic kidney disease (CKD), regardless of race or diabetes status, the use of an ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB) as initial therapy is recommended to improve kidney outcomes. In the general nonblack population (without CKD) including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic, calcium channel blocker, ACEI, or ARB. In the general black population (without CKD) including those with diabetes, initial antihypertensive treatment should consist of a thiazide-type diuretic or a calcium channel blocker instead of an ACEI or ARB. Diabetes and hypertension: The American Diabetes Association (ADA) guidelines suggest that for patients with hypertension and diabetes without albuminuria, any of the 4 classes of blood pressure medications (eg, ACE inhibitors, angiotensin receptor blockers, thiazide-like diuretics, dihydropyridine calcium channel blockers) may be used and have shown beneficial cardiovascular outcomes (ADA 2017a).