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" What is it used for?  High blood pressure (hypertension). Angina pectoris (as a regular treatment to help prevent attacks). A severe form of angina pectoris, not caused by exertion (Prinzmetal&amp;#039;s angina).   How does it work? Istin tablets contain the active ingredient amlodipine, which is a type of medicine called a calcium-channel blocker. Calcium-channel blockers act on the heart and blood vessels. (NB. Amlodipine tablets are also available without a brand name, ie as the generic medicine.) Amlodipine works by slowing the movement of calcium through the muscle cells that are found in the walls of blood vessels. It does this by blocking &amp;#039;calcium channels&amp;#039; in these muscle cells. Calcium is needed by muscle cells in order for them to contract, so by depriving them of calcium, amlodipine causes the muscle cells to relax.  Amlodipine acts specifically on the muscle cells in the walls of arteries, causing them to relax. This allows the arteries in the body to widen, an effect that has two main uses.  The relaxing and widening of the small arteries in the body decreases the resistance that the heart has to push against in order to pump the blood around the body. This reduces the pressure within the blood vessels. Amlodipine can therefore be used to treat high blood pressure.  The widening effect on the small arteries and the arteries in the heart also improves the blood and therefore oxygen supply to the heart. This feature means amlodipine can be used to treat angina. The chest pain of angina is caused by insufficient oxygen supply to the heart. As amlodipine improves this oxygen supply, and also reduces the effort the heart has to make to pump blood, it can be taken regularly to prevent angina attacks.    How do I take it?  Amlodipine tablets are taken once a day. You should try to take the medicine at the same time each day. The tablets should be swallowed with a drink of water. They can be taken either with or without food. If you forget to take a dose don&amp;#039;t worry, just leave out that dose and take your next dose as usual. Don&amp;#039;t take a double dose to make up for a missed dose.   Warning!  Dizziness and weariness may occasionally occur during treatment with blood pressure lowering medicines. Dizziness can be relieved by lying down until the symptoms pass. You should take extra care performing potentially hazardous tasks such as driving or operating machinery until you know how this medicine affects you and you are sure you can perform these activities safely.  If you experience any chest pain after taking this medicine you should not take a further dose until you have consulted your doctor.  This medicine should not be used to treat an attack of angina chest pain, as it won&amp;#039;t work quickly enough.  Your blood pressure should be regularly monitored while you are taking this medicine.    Use with caution in  Decreased liver function. Heart failure. Hereditary blood disorders called porphyrias.   Not to be used in  People allergic to related calcium-channel blockers (dihydropyridines, eg nifedipine). People with very low blood pressure (hypotension). A condition where the heart fails to maintain adequate circulation of blood (cardiogenic shock). Angina not well controlled by medical treatment (unstable angina). People with significant narrowing of the main artery that leaves the heart to supply blood to the body (aortic stenosis).  People with unstable heart failure following a heart attack. Pregnancy. Breastfeeding. This medicine is not licensed for children under six years of age.  This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.   Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  The safety of this medicine in pregnancy has not been established. It should not be used during pregnancy, unless your doctor feels it is essential for controlling your condition. This could be because leaving the condition uncontrolled would pose more risk to your baby than taking the medicine. Seek further medical advice from your doctor.  It is not known if amlodipine passes into breast milk. This medicine should therefore not be used during breastfeeding. Mothers will need to either stop breastfeeding while taking this medicine, or not take this medicine. This will depend on how important the medicine is for treating the mother&amp;#039;s condition. It is important to seek medical advice from your doctor.   Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.  Common (affect between 1 in 10 and 1 in 100 people)  Headache. Drowsiness.  Dizziness. Flushing. Awareness of your heartbeat (palpitations). Abdominal pain. Feeling sick. Excessive fluid retention in the body tissues, resulting in swelling (oedema). Fatigue.   Uncommon (affect between 1 in 100 and 1 in 1000 people)  Mood changes such as depression or anxiety. Difficulty sleeping (insomnia). Tremor. Taste changes. Pins and needles or numb sensations. Pain in the muscles or joints. Visual disturbances. Sensation of ringing, or other noise in the ears (tinnitus). Shortness of breath.  Disturbances of the gut such as vomiting, indigestion, diarrhoea. Dry mouth. Impotence.  Skin reactions such as rash, itching or sweating. Hair loss. Increased need to pass urine. Low blood pressure and fainting.  Chest pain. Feeling weak or unwell. Weight changes.   Very rare (affect less than 1 in 10,000 people)  Liver problems such as jaundice and hepatitis. Inflammation of the stomach (gastritis) or pancreas (pancreatitis). Enlargement of the gums (gingival hyperplasia). Severe allergic reactions. Nerve disorder called peripheral neuropathy. Decrease in the number of white blood cells or platelets in the blood (leucopenia or thrombocytopenia). Inflammation of blood vessels (vasculitis).  Irregular heartbeats. Heart attack.   The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.   How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe. If amlodipine is used in combination with other medicines that lower blood pressure, either to treat high blood pressure (antihypertensives), or as a side effect, the combination might lower your blood pressure too much. This could make you feel dizzy or faint, particularly when moving from a lying or sitting position to sitting or standing. This is more likely when you first start taking amlodipine with one of these medicines. If this happens to you, you should sit or lie down until the symptoms pass. Tell your doctor if any dizziness persists, as your medicine doses may need adjusting. Other medicines that decrease blood pressure include the following:   ACE inhibitors, eg enalapril aldesleukin alpha-blockers such as prazosin  alprostadil angiotensin II receptor antagonists such as losartan antipsychotics such as chlorpromazine benzodiazepines, eg temazepam, diazepam baclofen beta-blockers such as propranolol other calcium-channel blockers such as verapamil, nifedipine clonidine diazoxide diuretics, eg furosemide, bendroflumethiazide dopamine agonists, eg bromocriptine, apomorphine hydralazine levodopa MAOI antidepressants, eg phenelzine methyldopa minoxidil moxonidine moxisylyte nicorandil nitrates, eg glyceryl trinitrate sildenafil  tizanidine.  Amlodipine increases the blood level of the cholesterol-lowering medicine simvastatin and this could increase the chance of simvastatin having side effects on your muscles. Your dose of simvastatin should not be higher than 20mg daily if you are also taking amlodipine. The following medicines may increase the amount of amlodipine in your blood and this could increase the risk of its side effects:  clarithromycin diltiazem erythromycin itraconazole  ketoconazole protease inhibitors for HIV infection, eg ritonavir, nelfinavir, saquinavir  telithromycin verapamil.  If you take any of these with amlodipine, you should tell your doctor if you feel dizzy or experience any other side effects, as the dose of your amlodipine may need to be reduced.  The following medicines may increase the breakdown of amlodipine by the liver and could therefore make it less effective. If you take any of these in combination with amlodipine your doctor may need to increase your amlodipine dose:   carbamazepine phenytoin  phenobarbital rifampicin the herbal remedy St. John&amp;#039;s wort (Hypericum perforatum).  The following medicines may reduce the blood pressure lowering effect of this medicine:  corticosteroids, such as dexamethasone or prednisolone oestrogens, such as those in the contraceptive pill regular use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac or indomethacin (occasional painkilling doses are unlikely to have a significant effect).   Other medicines containing the same active ingredient Amlodipine tablets are also available without a brand name, ie as the generic medicine, and as the branded generic Amlostin.  Exforge contains amlodipine in combination with another blood pressure lowering medicine called valsartan. Sevikar contains amlodipine in combination with another blood pressure lowering medicine called olmesartan. Sevikar HCT contains amlodipine in combination with olmesartan and hydrochlorothiazide.   Last updated 14.10.2012 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/heart-and-blood/a6938/istin-amlodipine/>