Posology : מינונים

4.2 Posology and method of administration
Posology
Adults
For both hypertension and angina, the usual initial dose is 5 mg once daily which may be increased to a maximum dose of 10 mg depending on the individual patient's response.

In hypertensive patients, Norvasc has been used as monotherapy or in combination with a thiazide diuretic, alpha blocker, beta blocker, or an angiotensin converting enzyme inhibitor. For angina, Norvasc may be used as monotherapy or in combination with other antianginal medicinal products.
No dose adjustment of Norvasc is required upon concomitant administration of thiazide diuretics, beta blockers, and angiotensin-converting enzyme inhibitors.
Dosage should be adjusted according to each patient’s need. In general, titration should proceed over 7 to 14 days so that the physician can fully assess the patient’s response to each dose level. Titration may proceed more rapidly, however, if clinically warranted, provided the patient is assessed frequently.

Small, fragile or elderly individuals, or patients with hepatic insufficiency may be started on 2.5 mg once daily, and this dose may be used when adding Norvasc to other antihypertensive or antianginal drugs.

Increases in AUC and elimination half life in patients with congestive heart failure were as expected for the patient age group studied.

Special populations
Elderly patients
Norvasc used at similar doses in elderly or younger patients is equally well tolerated. Normal dosage regimens are recommended in the elderly but increase of the dosage should take place with care (see sections 4.4 and 5.2).


Patients with hepatic impairment
Dosage recommendations have not been established in patients with mild to moderate hepatic impairment; therefore, dose selection should be cautious and should start at the lower end of the dosing range (see sections 4.4 and 5.2). The pharmacokinetics of amlodipine have not been studied in severe hepatic impairment. Amlodipine should be initiated at the lowest dose and titrated slowly in patients with severe hepatic impairment.


Patients with renal impairment
Changes in amlodipine plasma concentrations are not correlated with degree of renal impairment, therefore the normal dosage is recommended. Amlodipine is not dialysable.

Paediatric population
Children and adolescents with hypertension from 6 years to 17 years of age The recommended antihypertensive oral dose in paediatric patients ages 6-17 years is 2.5 mg once daily as a starting dose, up-titrated to 5 mg once daily if blood pressure goal is not achieved after 4 weeks. Doses in excess of 5 mg daily have not been studied in paediatric patients (see sections 5.1 and 5.2).
Children under 6 years old
No data are available.


Method of administration
Tablet for oral administration.