Sampine Drug Interactions

CYP3A4 inhibitors: Concomitant use of S(-) Amlodipine with strong or moderate CYP3A4 inhibitors (protease inhibitors, azole antifungals, macrolides like erythromycin or clarithromycin, verapamil or diltiazem) may give rise to significant increase in amlodipine exposure. The clinical translation of these PK variations may be more pronounced in the elderly. Clinical monitoring and dose adjustment may thus be required.
CYP3A4 inducers: There is no data available regarding the effect of CYP3A4 inducers on S(-) Amlodipine. The concomitant use of CYP3A4 inducers (e.g., rifampicin, Hypericum perforatum) may give a lower plasma concentration of S(-) Amlodipine. S(-) Amlodipine should be used with caution together with CYP3A4 inducers.
Administration of S(-) Amlodipine with grapefruit or grapefruit juice is not recommended as bioavailability may be increased in some patients resulting in increased blood pressure lowering effects.
Dantrolene (infusion): In animals, lethal ventricular fibrillation and cardiovascular collapse are observed in association with hyperkalemia after administration of verapamil and dantrolene I.V. Due to risk of hyperkalemia, it is recommended that the co administration of calcium channel blockers such as S(-) Amlodipine be avoided in patients susceptible to malignant hyperthermia and in the management of malignant hyperthermia.
Effects of S(-) Amlodipine on other medicinal products: The blood pressure lowering effects of S(-) Amlodipine adds to the blood pressure-lowering effects of other medicinal products with antihypertensive properties.
Simvastatin: Limit the dose of simvastatin in patients on S(-) Amlodipine to 20 mg daily.