Norvasc

Leaflet accompanying the packaging: patient information

Warning! Keep the leaflet, the information on the immediate packaging is in a foreign language!

Norvasc

10 mg, tablets
Amlodipine

You should carefully read the contents of the leaflet before taking the medicine, as it contains important information for the patient.

• You should keep this leaflet, so that you can read it again if necessary.
• In case of any doubts, you should consult a doctor or pharmacist.
• This medicine has been prescribed to a specific person. It should not be given to others. The medicine may harm another person, even if the symptoms of their illness are the same.
• If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet:

• 1. What is Norvasc and what is it used for
• 2. Important information before taking Norvasc
• 3. How to take Norvasc
• 4. Possible side effects
• 5. How to store Norvasc
• 6. Contents of the pack and other information

1. What is Norvasc and what is it used for

Norvasc contains the active substance amlodipine, which belongs to a group of medicines called calcium antagonists.
Norvasc is used to treat high blood pressure (hypertension) or chest pain (angina pectoris) and its rare form called Prinzmetal's angina (vasospastic angina).
In patients with high blood pressure, this medicine widens the blood vessels so that blood can flow more easily.
In patients with coronary heart disease, Norvasc makes it easier for blood to reach the heart muscle, increasing the amount of oxygen delivered, which in turn prevents chest pain.
This medicine does not provide immediate relief from chest pain caused by angina.

2. Important information before taking Norvasc

When not to take Norvasc

Warnings and precautions

Before starting to take Norvasc, the patient should discuss it with their doctor or pharmacist.
The patient should inform their doctor if they have or have had:

• Recently had a heart attack
• Heart failure
• Significant increase in blood pressure (hypertensive crisis)
• Liver disease
• Necessity to increase the dose in elderly patients

Children and adolescents

No studies have been conducted on the use of Norvasc in children under 6 years of age. Norvasc can only be used to treat high blood pressure in children and adolescents from 6 to 17 years old (see section 3).
To obtain further information, the patient should consult their doctor.

Norvasc and other medicines

The patient should tell their doctor or pharmacist about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take.
Norvasc may interact with other medicines or other medicines may interact with Norvasc:

• ketokonazole, itraconazole (antifungal medicines)
• ritonavir, indinavir, nelfinavir (protease inhibitors used to treat HIV)
• rifampicin, erythromycin, clarithromycin (antibiotics)
• St. John's Wort
• verapamil, diltiazem (medicines used to treat heart conditions)
• dantrolene (used in severe body temperature disorders)
• tacrolimus, sirolimus, temsirolimus, and everolimus (medicines that suppress the patient's immune system)
• simvastatin (a medicine that lowers cholesterol levels)
• cyclosporin (an immunosuppressive medicine)

Norvasc may lower blood pressure more when the patient takes other blood pressure-lowering medicines.

Norvasc with food and drink

Patients taking Norvasc should not consume grapefruit juice or grapefruits, as they may increase the levels of the active substance amlodipine in the blood, which may lead to an unexpected increase in the effect of Norvasc, lowering blood pressure.

Pregnancy and breastfeeding

Pregnancy
There is no data on the safety of amlodipine in pregnancy. If the patient suspects pregnancy or plans to become pregnant, they should inform their doctor before taking Norvasc.
Breastfeeding
It has been shown that small amounts of amlodipine pass into breast milk. If the patient is breastfeeding or plans to breastfeed, they should inform their doctor before taking Norvasc.
Before taking any medicine, the patient should consult their doctor or pharmacist.

Driving and using machines

Norvasc may affect the patient's ability to drive and use machines. If the tablets cause nausea, dizziness, or fatigue, or headache, the patient should not drive or operate machinery; they should contact their doctor immediately.

Norvasc contains sodium

The medicine contains less than 1 mmol (23 mg) of sodium per tablet, which means the medicine is considered "sodium-free".

3. How to take Norvasc

This medicine should always be taken as directed by the doctor or pharmacist. In case of doubts, the patient should consult their doctor or pharmacist.
Norvasc is available in 5 mg and 10 mg doses.
The recommended initial dose of Norvasc is 5 mg once a day. The dose may be increased to 10 mg once a day.
This medicine can be taken with or without food and drinks. It is recommended to take this medicine every day at the same time, with a glass of water. Norvasc should not be taken with grapefruit juice.

Use in children and adolescents

In children and adolescents (6-17 years old), the usual initial dose is 2.5 mg per day.
The maximum recommended dose is 5 mg per day. Norvasc 5 mg tablets can be divided into halves to obtain a 2.5 mg dose.
It is essential to take the tablets continuously. The patient should not wait until all the tablets have been used before visiting their doctor.

Taking more than the recommended dose of Norvasc

Taking too many tablets may cause a decrease or even a dangerous decrease in blood pressure. The patient may experience dizziness, a feeling of "emptiness" in the head, fainting, or weakness. In case of a significant decrease in blood pressure, shock may occur. The skin becomes cold and wet, and the patient may lose consciousness. If the patient has taken too many Norvasc tablets, they should contact their doctor or go to the emergency department of the nearest hospital immediately.

Missing a dose of Norvasc

The patient should remain calm. If they forget to take a tablet, they should skip it.
The patient should take the next dose at the usual time. They should not take a double dose to make up for the missed dose.

Stopping Norvasc treatment

The doctor will inform the patient how long they should take this medicine. If the patient stops taking this medicine before their doctor advises, their illness may worsen.
If the patient has any further doubts about taking this medicine, they should consult their doctor or pharmacist.

4. Possible side effects

Like all medicines, Norvasc can cause side effects, although not everybody gets them.
The patient should immediatelycontact their doctor if they experience any of the following side effects after taking Norvasc.

• Sudden wheezing, chest pain, shortness of breath, or difficulty breathing
• Swelling of the eyelids, face, or lips
• Swelling of the tongue and throat, causing severe breathing difficulties
• Severe skin reactions, including severe rash, hives, redness of the skin all over the body, intense itching, blisters, peeling, and skin swelling, as well as inflammation of the mucous membranes (Stevens-Johnson syndrome, toxic epidermal necrolysis) or other allergic reactions
• Heart attack, arrhythmias
• Pancreatitis, which can cause severe abdominal pain radiating to the back, with very poor general condition

Very common side effects: occurring in at least 1 in 10 patients

• Swelling (fluid retention)

The following common side effectshave been reported. If any of these side effects are troublesome for the patient or last for more than a week, they should contact their doctor.

Common side effects: occurring in less than 1 in 10 patients

• Headache, dizziness, drowsiness (especially at the beginning of treatment)
• Palpitations (awareness of heartbeat), flushing of the face
• Abdominal pain, nausea
• Changes in bowel movements, diarrhea, constipation, indigestion
• Fatigue, weakness
• Visual disturbances, double vision
• Muscle cramps
• Swelling of the ankles

Uncommon side effects: occurring in less than 1 in 100 patients

• Mood changes, anxiety, depression, insomnia
• Tremors, taste disturbances, fainting
• Numbness or tingling of limbs, loss of pain sensation
• Tinnitus
• Low blood pressure
• Sneezing/runny nose caused by inflammation of the nasal mucosa (rhinitis)
• Cough
• Dryness of the mucous membranes of the mouth, vomiting
• Hair loss, increased sweating, itching of the skin, red spots on the skin, skin discoloration
• Urination disorders, increased need to urinate at night, increased frequency of urination
• Sexual dysfunction, discomfort or enlargement of the breasts in men
• Pain, poor general condition
• Pain in the joints or muscles, back pain
• Weight gain or loss

Rare side effects: occurring in less than 1 in 1,000 patients

• Disorientation

Very rare side effects: occurring in less than 1 in 10,000 patients

• Decreased white blood cell count, decreased platelet count, which may lead to unusual bruising and easier bleeding
• High blood sugar levels (hyperglycemia)
• Nerve disorders that can cause muscle weakness, tingling, or numbness
• Gum swelling, gum bleeding
• Abdominal bloating (gastritis)
• Abnormal liver function, liver inflammation, yellowing of the skin (jaundice), increased liver enzyme activity, found in blood tests
• Increased muscle tension
• Vasculitis, often with skin rash
• Sensitivity to light
• Disorders including stiffness, tremors, and (or) difficulty moving

Frequency not known: cannot be estimated from the available data

• Tremors, stiff posture, mask-like face, slow movements, and a shuffling, unbalanced gait

Reporting side effects

If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products:
Al. Jerozolimskie 181C
02-222 Warsaw
tel.: +48 22 49 21 301
fax: +48 22 49 21 309
website: https://smz.ezdrowie.gov.pl
By reporting side effects, more information can be gathered on the safety of the medicine.

5. How to store Norvasc

The medicine should be stored out of sight and reach of children.
The patient should not use this medicine after the expiry date stated on the carton after: EXP. The expiry date refers to the last day of the month.
The medicine should not be stored above 25°C.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines they no longer use. This will help protect the environment.

6. Contents of the pack and other information

What Norvasc contains

The active substance of Norvasc is amlodipine.
Each tablet contains 10 mg of amlodipine (as amlodipine besylate).
The other ingredients are: microcrystalline cellulose, calcium hydrogen phosphate, sodium carboxymethylcellulose (type A), magnesium stearate.

What Norvasc looks like and contents of the pack

White or almost white, octagonal tablets with "AML-10" on one side and "Pfizer" on the other side of the tablet.
Norvasc 10 mg tablets are available in blisters containing 30 tablets.
To obtain more detailed information, the patient should consult the marketing authorization holder or parallel importer.

Marketing authorization holder in Romania, the country of export:

Upjohn EESV
Rivium Westlaan 142
2909 LD Capelle aan den IJssel
Netherlands

Manufacturer:

Pfizer Manufacturing Deutschland GmbH
Betriebsstätte Freiburg
Mooswaldallee 1
79090 Freiburg
Germany
R-Pharm Germany GmbH
Heinrich-Mack-Str. 35
89257 Illertissen
Germany

Parallel importer:

Pharmapoint SA
ul. Zbąszyńska 3
91-342 Łódź

Repackaged by:

Laboratorium Galenowe Olsztyn Sp. z o.o.
ul. Spółdzielcza 25A
11-001 Dywity
Prodlekpol Sp. z o.o.
ul. Chełmżyńska 249
04-458 Warsaw
Pharma Innovations Sp. z o.o.
ul. Jagiellońska 76
03-301 Warsaw
Marketing authorization number in Romania, the country of export: 5655/2013/01
Parallel import authorization number: 189/18

This medicinal product is authorized in the Member States of the European Economic Area under the following names:

Tablets:
Austria, Bulgaria, Denmark, Estonia, Finland, Germany, Iceland, Hungary, Italy, Latvia, Lithuania, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Sweden: Norvasc
Czech Republic: Zorem
Ireland, Malta, United Kingdom: Istin
Ireland: Amlodipine Upjohn 5 mg tablets, Amlodipine Upjohn 10 mg tablets
Italy: Amlodipina Pfizer Italia
Spain: Norvas 5 mg comprimidos, Norvas 10 mg comprimidos;
United Kingdom: Amlodipine