Amlodine HD Special Precautions

Heart failure. Hepatic impairment & alcohol consumption. Skeletal muscle effects: Discontinue in patients w/ myopathy or having a risk factor predisposing to the development of renal failure secondary to rhabdomyolysis.
Amlodipine should be used with caution in patients with hypotension, in patients whose cardiac reserve is poor, and in those with heart failure since deterioration of heart failure has been noted. It should not be used in cardiogenic shock, in patients who have recently suffered a myocardial infarction, or in acute unstable angina. It should not be used to treat an anginal attack in chronic stable angina. In patients with severe aortic stenosis it may increase the risk of developing heart failure. Sudden withdrawal might be associated with an exacerbation of angina. The dose may need to be reduced in patients with hepatic impairment. It should be discontinued in patients who experience ischaemic pain following its administration.
Atorvastatin should not be given to patients with active liver disease or unexplained persistently raised serum-aminotransferase concentrations and should be discontinued if marked or persistent increases in serum-aminotransferase concentrations occur. They should be avoided during pregnancy since there is a possibility that they could interfere with fetal sterol synthesis; there have been a number of reports of congenital abnormalities associated with statins. Statins may cause myopathy and rhabdomyolysis, especially at higher doses, and they should be used with caution in patient at risk of rhabdomyolysis, and particularly in patients taking drugs that increase plasma concentrations of the statin; the statin should be discontinued if creatine phosphokinase increases significantly or if myopathy is diagnosed. Some statins, such as fluvastatin, pravastatin, rosuvastatin, and simvastatin, should be used with caution in patients with severe renal impairment.