Norvasc

Patient Information Leaflet: User Information

Warning! The leaflet should be kept. Information on the immediate packaging in a foreign language.

Norvasc (NORVASC), 10 mg, tablets

Amlodipine
Norvasc and НОРВАСК are the same trade names for the same drug, written in Polish and Bulgarian.

Before using the medicine, you should carefully read the contents of the leaflet, as it contains important information for the patient.

• The leaflet should be kept so that it can be read 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 using Norvasc
• 3. How to use Norvasc
• 4. Possible side effects
• 5. How to store Norvasc
• 6. Contents of the packaging 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 indicated for the treatment of high blood pressure (hypertension) or chest pain, known as angina pectoris, and its rare form known as 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 facilitates blood flow to 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 using Norvasc

When not to use Norvasc

• if the patient has been found to be hypersensitive (allergic) to amlodipine or any of the other ingredients of this medicine listed in section 6, or to any other calcium antagonist. Symptoms may include itching, skin rash, or difficulty breathing,
• if the patient has very low blood pressure (hypotension),
• if the patient has narrowing of the aortic valve (aortic stenosis) or cardiogenic shock (a condition in which the heart cannot supply enough blood to the body),
• if the patient has heart failure after a heart attack.

Warnings and precautions

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

• a recent heart attack,
• heart failure,
• significant increase in blood pressure (hypertensive crisis),
• liver disease,
• a need 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 temperature regulation 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 is taking other antihypertensive 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 using amlodipine during pregnancy. If the patient suspects pregnancy or plans to become pregnant, they should tell their doctor before using Norvasc.
Breastfeeding
It has been shown that small amounts of amlodipine pass into human milk. If the patient is breastfeeding or plans to breastfeed, they should tell their doctor before starting to use Norvasc.
Before using 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 use Norvasc

This medicine should always be used 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 recommended initial dose is usually 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.

Using 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 cool and moist, 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.
Even 24-48 hours after taking the medicine, shortness of breath due to excess fluid accumulating in the lungs (pulmonary edema) may occur.

Missing a dose of Norvasc

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

Stopping the use of Norvasc

The doctor will inform the patient how long they should use this medicine. If the patient stops using this medicine before their doctor recommends it, the illness may recur.
If the patient has any further doubts about using 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 using the medicine:

• 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 difficulty in breathing,
• 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.

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

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 more than a week, they should contact their doctor.

Common side effects: occurring in no more 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,
• change in bowel movements, diarrhea, constipation, indigestion,
• fatigue, weakness,
• vision disturbances, double vision,
• muscle cramps,
• swelling of the ankles.

Other reported side effects are listed below. If any of these side effects worsen or if the patient experiences any side effects not listed in the leaflet, they should tell their doctor or pharmacist.

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

• mood changes, anxiety, depression, insomnia,
• tremors, taste disturbances, fainting,
• numbness or tingling of the limbs, lack of pain sensation,
• tinnitus,
• low blood pressure,
• rhinitis (runny nose),
• 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,
• erectile dysfunction, discomfort or enlargement of the breasts in men,
• pain, poor general condition,
• joint or muscle pain, back pain,
• weight gain or loss.

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

• disorientation.

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

• decrease in white blood cell count, decrease in 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 distension (gastritis),
• abnormal liver function, liver inflammation, yellowing of the skin (jaundice), increased liver enzyme activity, as shown in blood tests,
• increased muscle tone,
• vasculitis, often with skin rash,
• sensitivity to light,
• disorders including stiffness, tremors, and (or) difficulty in movement.

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 the 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 collected on the safety of the medicine.

5. How to store Norvasc

The medicine should be stored out of sight and reach of children.
The medicine should not be used after the expiry date stated on the packaging. The expiry date refers to the last day of the month.
Store in a temperature below 25°C.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the packaging 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: calcium hydrogen phosphate, magnesium stearate, microcrystalline cellulose, sodium carboxymethylcellulose (type A).

What Norvasc looks like and contents of the pack

White or almost white octagonal tablets with beveled edges, with the inscription "AML-10" on one side and the "Pfizer" logo on the other side. The tablet can be divided into equal doses.
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 Bulgaria, 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

Parallel importer:

Delfarma Sp. z o.o.
ul. Św. Teresy od Dzieciątka Jezus 111
91-222 Łódź

Repackaged by:

Delfarma Sp. z o.o.
ul. Św. Teresy od Dzieciątka Jezus 111
91-222 Łódź
Marketing authorization number in Bulgaria, the country of export: 20000436

Parallel import authorization number: 380/24

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 10 mg tablets
Italy: Amlodipina Pfizer Italia
Spain: Norvas 10 mg comprimidos
United Kingdom: Amlodipine
Date of approval of the leaflet:29.10.2024
[Information about the trademark]