Levamdocal 1.25

Indications

Levamdocal, a calcium channel blocker, is used to treat hypertension either alone or in combination with other antihypertensive medications. By lowering blood pressure, it helps reduce the risk of cardiovascular events such as strokes and myocardial infarctions.

Pharmacology

Levamlodipine is effective for managing hypertension in adults and children aged 6 years and older. As a dihydropyridine calcium antagonist, it prevents calcium ions from entering vascular smooth muscle and cardiac cells, thereby lowering blood pressure. Levamlodipine is the active isomer of the racemic mixture found in amlodipine.

• Absorption: Oral Levamlodipine is absorbed with a Tmax of 6-12 hours and a bioavailability of 64-90%. Its absorption is unaffected by food.
• Distribution: It has a volume of distribution similar to amlodipine, approximately 21 L/kg.
• Metabolism and Excretion: Levamlodipine is 90% metabolized to inactive forms, primarily by CYP3A4, and 60% is eliminated through urine, with 10% as the unmetabolized drug.

Dosage & Administration

• Route: Oral administration.
• Dosage: Start with 2.5 mg once daily, with a maximum of 5 mg daily. Elderly patients or those with hepatic insufficiency may start with 1.25 mg daily. Dosage adjustments should be made based on blood pressure goals, with a 7-14 day interval between titration steps.
• Children and Adolescents: For ages 6-17, the recommended dose is 1.25 to 2.5 mg daily. Higher doses have not been studied.

Interactions

• CYP3A Inhibitors: May increase amlodipine exposure; dose reduction may be needed.
• CYP3A Inducers: Effects on amlodipine are not well-documented.
• Simvastatin: Co-administration may increase simvastatin levels; limit to 20 mg daily.
• Immunosuppressants: May increase levels of cyclosporine or tacrolimus; monitor and adjust doses as needed.
• Food and Other Interactions: Can be taken with or without food. Avoid grapefruit and natural licorice.

Contraindications

Levamdocal should not be used in patients with known sensitivity to amlodipine.

Side Effects

• Common: Difficulty breathing, dizziness, reflex tachycardia, hypotension, abdominal pain, edema.
• Rare: Diarrhea, back pain, headache, fatigue, nausea.

Pregnancy & Lactation

Data on the use of amlodipine during pregnancy are limited, and no adverse effects on breastfed infants have been observed.

Precautions & Warnings

• Hypotension: Risk of symptomatic hypotension, especially in patients with severe aortic stenosis.
• Increased Angina or Myocardial Infarction: Possible worsening of angina or acute myocardial infarction, particularly in patients with severe coronary artery disease.
• Hepatic Failure: Titrate slowly in patients with severe hepatic impairment due to extensive liver metabolism.

Overdose Effects

Overdose may cause excessive peripheral vasodilation, marked hypotension, and possible reflex tachycardia.

Therapeutic Class

Calcium channel blockers.

Storage Conditions

Store in a cool, dry place, away from light and moisture. Keep out of reach of children.