Sampine Special Precautions

The safety and efficacy of S(-) Amlodipine in hypertensive crisis has not been established.
Patients with cardiac failure: Patients with heart failure should be treated with caution. Calcium channel blockers, including S(-) Amlodipine, should be used with caution in patients with congestive heart failure, as they may increase the risk of future cardiovascular events and mortality.
Use in patients with impaired hepatic function: The half-life of S(-) Amlodipine is prolonged and AUC values are higher in patients with impaired liver function; dosage recommendations have not been established. S(-) Amlodipine should therefore be initiated at the lower end of the dosing range and caution should be used, both on initial treatment and when increasing the dose. Slow dose titration and careful monitoring may be required in patients with severe hepatic impairment.
Use in renal failure: S(-) Amlodipine may be used in such patients at normal doses. Changes in S(-) Amlodipine plasma concentrations are not correlated with degree of renal impairment. S(-) Amlodipine is not dialyzable.
Effects on Ability to Drive and Use Machines: S(-) Amlodipine can have minor or moderate influence on the ability to drive and use machines. If patients taking S(-) Amlodipine suffer from dizziness, headache, fatigue or nausea the ability to react may be impaired. Caution is recommended especially at the start of treatment.
Use in the Elderly: In the elderly increase of the dosage should take place with care.