Use in patients with heart failure: In a long term, placebo controlled study (PRISE-2) of ALMOBEST, in patients with NYHA III and IV heart failure of nonischaemic aetiology, amlodipine was associated with increased reports of pulmonary oedema despite no significant difference in the incidence of worsening heart failure as compared to placebo. See "Pharmacology under Actions".
Use in patients with impaired hepatic function: As with all calcium antagonists, amlodipine's half-life is prolonged in patients with impaired liver function and dosage recommendations have not been established. The drug should therefore be administered with caution in these patients.
There are no data to support the use if ALMOBEST alone, during or within one month of a myocardial infarction.
The safety and efficacy of ALMOBEST in hypertensive crisis has not been established.
Effects on ability to drive and use machines: Clinical experience with ALMOBEST indicates that therapy is unlikely to impair a patient’s ability to drive or use machinery.