Logimax Special Precautions

Combination treatment with digitalis. Felodipine/Metoprolol succinate (LOGIMAX) can exacerbate the symptoms of peripheral vascular disease, e.g. intermittent claudication. Severely impaired renal function (GFR <30 mL/min). Aortic stenosis. Impaired hepatic function. Heart failure following acute myocardial infarction. Acute myocardial infarction. Hypotension, which in susceptible subjects can cause myocardial ischemia. Severe acute pathological conditions with metabolic acidosis.
Felodipine/Metoprolol succinate (LOGIMAX) must not be used for first treatment of previously untreated patients.
Felodipine/Metoprolol succinate (LOGIMAX) should not be given to patients with latent or manifest cardiac insufficiency without concomitant treatment of this.
Treatment with Felodipine/Metoprolol succinate (LOGIMAX) may affect carbohydrate metabolism or mask hypoglycemia, but the risk is less than with non-selective β-receptor blockers.
In isolated cases an existing moderate disturbance of AV-conduction time may be exacerbated (possibly leading to AV block).
Intravenous administration of verapamil must not be given to patients being treated with Felodipine/Metoprolol succinate (LOGIMAX).
In patients with Prinzmetal's angina the number and severity of angina attacks may increase, due to α-receptor-mediated constriction of coronary vessels. Non-selective β-blockers therefore must not be used for these patients. β₁-selective receptor blockers must be used with care.
In cases of bronchial asthma or other chronic obstructive pulmonary diseases adequate bronchodilator therapy must be given concomitantly. The dose of β₂-stimulants may need to be increased.
Treatment with β-blockers may make the treatment of an anaphylactic reaction more difficult. Adrenaline treatment in normal doses does not always produce the expected therapeutic effect.
If Felodipine/Metoprolol succinate (LOGIMAX) is given to patients with pheochromocytoma, treatment with α-blockers should be considered.
Concomitant administration of drugs that induce CYP3A4 leads to greatly reduced levels of felodipine and the risk of a lack of effect (see Interactions). This combination should be avoided.
Concomitant administration of drugs that are potent inhibitors of CYP3A4 leads to greatly increased levels of felodipine (see Interactions). This combination should be avoided. Concomitant ingestion of grapefruit juice leads to greatly increased levels of felodipine (see Interactions). This combination should be avoided. Concomitant ingestion of grapefruit juice leads to greatly increased levels of felodipine (see Interactions). This combination should be avoided.
Abrupt discontinuation of β-blockade, especially in high-risk patients, can be risky and can exacerbate chronic heart failure and increase the risk of myocardial infarction and sudden death. If possible, any discontinuation of Felodipine/Metoprolol succinate (LOGIMAX) should therefore take place gradually over a period of 1-2 weeks.
Prior to surgery, the anesthetist must be informed that the patient is on Felodipine/Metoprolol succinate (LOGIMAX). It is recommended that β-blocker treatment is not withdrawn in patients who are undergoing surgery.
Effects on ability to drive and use machines: Since dizziness and fatigue can occur during treatment with Felodipine/Metoprolol succinate (LOGIMAX), this should be taken into account when increased alertness is required, e.g. when driving or using machines.