Home Drug Guide Levamlodipine Maleate

Drug Guide

Generic Name

Levamlodipine Maleate

Brand Names Conjupri

Classification

Therapeutic: Antihypertensive

Pharmacological: Calcium Channel Blocker

FDA Approved Indications

  • Hypertension (high blood pressure)

Mechanism of Action

Levamlodipine maleate is a racemic mixture, with the pharmacologically active S-isomer inhibiting calcium influx into vascular smooth muscle and cardiac muscle, leading to vasodilation and decreased blood pressure.

Dosage and Administration

Adult: Typically, 2.5 to 10 mg once daily, adjusted based on response.

Pediatric: Not commonly used in pediatrics; consult specific guidelines.

Geriatric: Start at lower doses due to increased sensitivity and comorbidities, monitor closely.

Renal Impairment: Adjust doses cautiously; no specific dosage adjustment, but monitor blood pressure and renal function.

Hepatic Impairment: Use with caution; start at lower doses due to reduced metabolism.

Pharmacokinetics

Absorption: Well absorbed orally, with peak plasma levels in about 6-12 hours.

Distribution: Extensively protein-bound (~97%), distributed widely.

Metabolism: Primarily hepatic via CYP3A4 to inactive metabolites.

Excretion: Excreted mainly in urine (about 60%) and feces.

Half Life: Approximately 30-50 hours, allowing for once-daily dosing.

Contraindications

  • Hypersensitivity to amlodipine or other dihydropyridines.
  • Severe aortic stenosis.

Precautions

  • Use cautiously in patients with congestive heart failure, liver impairment, or recent myocardial infarction. Risks of hypotension and edema should be monitored.

Adverse Reactions - Common

  • Peripheral edema (Common)
  • Flushing (Common)
  • Dizziness (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Hypotension (Uncommon)
  • Bradycardia or arrhythmia (Uncommon)
  • Myocardial ischemia (Rare)

Drug-Drug Interactions

  • Simvastatin and other CYP3A4 substrates (may increase levels)
  • Beta blockers (additive effects on heart rate and blood pressure)
  • Other antihypertensives (monitor for excessive hypotension)

Drug-Food Interactions

  • Grapefruit juice (may increase plasma levels)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure and heart rate regularly. Assess for signs of edema, dizziness, or adverse cardiovascular effects.

Diagnoses:

  • Ineffective tissue perfusion related to vasodilation leading to hypotension.
  • Risk for falls due to dizziness or hypotension.

Implementation: Administer consistently at the same time each day. Educate patient on monitoring blood pressure at home.

Evaluation: Evaluate reduction in blood pressure and monitor for adverse effects; adjust dosage as necessary.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Do not abruptly stop medication.
  • Limit alcohol and grapefruit juice.
  • Report symptoms like severe dizziness, swelling, or chest pain.

Special Considerations

Black Box Warnings:

  • None specifically for levamlodipine.

Genetic Factors: None currently known.

Lab Test Interference: May affect laboratory assessments of liver function or kidney function.

Overdose Management

Signs/Symptoms: Severe hypotension, tachycardia or bradycardia, dizziness, and possibly shock.

Treatment: Supportive care, intravenous fluids, vasopressors for hypotension, occasionally calcium administration if indicated.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions for the duration of the shelf life.

🛡️ 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.