Home Drug Guide Amlodipine Besylate and Atorvastatin Calcium

Drug Guide

Generic Name

Amlodipine Besylate and Atorvastatin Calcium

Brand Names Caduet

Classification

Therapeutic: Antihypertensive, Lipid-Lowering Agent

Pharmacological: Calcium Channel Blocker, HMG-CoA Reductase Inhibitor

FDA Approved Indications

  • Hypertension
  • Dyslipidemia (high cholesterol)

Mechanism of Action

Amlodipine inhibits calcium influx into vascular smooth muscle and cardiac muscle, leading to vasodilation. Atorvastatin inhibits HMG-CoA reductase, reducing cholesterol synthesis in the liver.

Dosage and Administration

Adult: As prescribed, typically once daily, dosage depends on patient response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: Start at lower dose, monitor closely due to increased risk of adverse effects.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution; contraindicated in active liver disease.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; highly protein-bound.

Metabolism: Amlodipine is extensively metabolized in the liver; atorvastatin is metabolized primarily by CYP3A4.

Excretion: Amlodipine excreted mainly via urine; atorvastatin predominantly excreted in bile.

Half Life: Amlodipine: ~30-50 hours; Atorvastatin: ~14 hours.

Contraindications

  • Hypersensitivity to amlodipine or atorvastatin.
  • Active liver disease, unexplained persistent elevations of serum transaminases.

Precautions

  • Use cautiously in patients with congestive heart failure, hypotension, or renal impairment. Monitor liver function and lipid levels periodically.

Adverse Reactions - Common

  • Dizziness (Common)
  • Peripheral edema (Common)
  • Muscle pain (Less common)

Adverse Reactions - Serious

  • Myopathy/rhabdomyolysis (Rare)
  • Hepatotoxicity (Rare)
  • Allergic reactions (Rare)

Drug-Drug Interactions

  • Simvastatin, lovastatin (avoid co-administration due to increased risk of myopathy)
  • Grapefruit juice (inhibits CYP3A4, increasing statin levels)

Drug-Food Interactions

  • Grapefruit juice

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, lipid profile, liver enzymes, and muscle symptoms.

Diagnoses:

  • Risk for hypotension
  • Risk for muscle injury
  • Risk for hepatotoxicity

Implementation: Administer once daily; monitor patient response; educate patient on signs of adverse effects.

Evaluation: Evaluate blood pressure, lipid levels, and adherence regularly.

Patient/Family Teaching

  • Take medication as prescribed.
  • Report muscle pain, weakness, or symptoms of liver problems.
  • Avoid grapefruit juice and discuss other potential food interactions.
  • Follow up for lab tests as scheduled.

Special Considerations

Black Box Warnings:

  • Myopathy and rhabdomyolysis; risk increased with concomitant use of certain drugs.
  • Hepatotoxicity; hepatic function should be monitored.
  • Not indicated for use in children.

Genetic Factors: Patients with certain genetic variants may have increased risk of statin-related side effects.

Lab Test Interference: Statins may slightly elevate liver enzymes; monitor periodically.

Overdose Management

Signs/Symptoms: Severe hypotension, tachycardia or bradycardia, muscle pain, hepatic dysfunction.

Treatment: Supportive care; activated charcoal if ingestion is recent; monitor cardiac and hepatic function; manage hypotension with IV fluids or vasopressors as needed.

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.