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Norvasc is a calcium channel blocker used to control high blood pressure or angina (chest pain). High blood pressure reduction helps prevent strokes, heart attacks and kidney problems. It relaxes your blood vessels so your heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart to control chest pain (angina).

Norvasc ®
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Norvasc
2.5 mg 30 Tabs FREE
  
Norvasc
2.5 mg 90 Tabs FREE
  
Norvasc
5 mg 30 Tabs FREE
  
Norvasc
5 mg 90 Tabs FREE
  
Norvasc
10 mg 30 Tabs FREE
  
Norvasc
10 mg 90 Tabs FREE
  
           

Norvasc ®

Chemical Name : Amlodipine

Important Note
The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

Uses
Norvasc / Amlodipine is prescribed for angina, a condition characterized by episodes of crushing chest pain that usually results from a lack of oxygen in the heart muscle due to clogged arteries. Amlodipine is also prescribed for high blood pressure.

Amlodipine belongs to a class of medications called calcium channel blockers. These medications block the transport of calcium into the smooth muscle cells lining the coronary arteries and other arteries of the body. Since calcium is important in muscle contraction, blocking calcium transport relaxes artery muscles and dilates coronary arteries and other arteries of the body. By relaxing coronary arteries, Norvasc is useful in preventing chest pain (angina) resulting from coronary artery spasm. Relaxing the muscles lining the arteries of the rest of the body lowers the blood pressure, which reduces the burden on the heart as it pumps blood to the body. Reducing heart burden lessens the heart muscle's demand for oxygen, and further helps to prevent angina in patients with coronary artery disease.

How to Use
Norvasc comes as a tablet to be taken by mouth. It is usually taken once a day, preferably with food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Amlodipine exactly as directed.

Usual Dosage for High Blood Pressure - The usual starting Amlodipine dose is 5 mg taken once a day. The maximum you should take in a day is 10 mg. A lower 2.5 mg starting dose applies if you have liver disease. Older Adults are usually prescribed a lower starting Amlodipine dose of 2.5 milligrams.

Usual Dosage for Angina - The usual starting Amlodipine dose is 5 to 10 milligrams once daily. The usual starting Amlodipine dose is 5 milligrams. A lower 5 mg starting dose applies if you have liver disease. Your doctor may adjust the dose based on your response to the drug.

Do not take more or less of it or take it more often than prescribed by your doctor. Amlodipine controls high blood pressure and chest pain (angina) but does not cure them. Continue to take Amlodipine even if you feel well. Do not stop taking amlodipine without talking to your doctor.

Side Effects
Although side effects from Norvasc are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away: headache, upset stomach, dizziness or lightheadedness, excessive tiredness, flushing (feeling of warmth), heartburn, fast heartbeat, muscle cramps, nosebleed, decreased sexual ability. If you experience any of the following symptoms, call your doctor immediately: swelling of the face eyes, lips, tongue, arms, or legs; difficulty breathing or swallowing; fast or irregular heartbeat; fainting; rash; yellowing of the skin or eyes; tender, bleeding, or swollen gums; worsening chest pain (attacks are more frequent, more severe, or last longer);

Precautions
Before taking Norvasc, tell your doctor if you have liver disease; or another disease of the heart or blood vessels such as sick sinus syndrome, aortic stenosis, heart failure, low blood pressure, or coronary artery disease. You may not be able to take Norvasc, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Norvasc is in the FDA pregnancy category C; this means that it is not known whether Norvasc will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Norvasc passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. .

Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately.The following symptoms indicate an overdose: dizziness; fainting; fast heartbeat.

Missed Dose
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not take a double dose to make up for a missed one.

Storage
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed.

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Amlodipine () Gynaecomastia : We report only the second published confirmed case of gynaecomastia caused by Amlodipine () (a dihydropyridine calcium channel blocker). Gynaecomastia developed in a 70-year-old male within 3 months of starting Amlodipine (), and symptoms resolved within 3 weeks of drug withdrawal suggesting a strong relationship between Amlodipine () and gynaecomastia in this patient. Recent research has suggested possible interesting novel mechanisms for Amlodipine () gynaecomastia.

Amlodipine () increases endothelial nitric oxide by dual mechanisms : Several experimental and clinical studies have demonstrated the antiatherogenic profile of the long-acting calcium antagonist Amlodipine (). Given the pivotal role of endothelial (dys)function during atherogenesis, we investigated the influence of Amlodipine () on endothelial nitric oxide (NO) bioavailability.

Acute addition of Amlodipine () to segments of porcine coronary arteries resulted in a significant increase in NO release which could be blocked by the NO synthase inhibitor L-NMMA (N-monomethylarginine). This effect was mirrored by a rise in intracellular cGMP levels in porcine endothelial cell cultures. Long-term (24 h) treatment of porcine endothelial cell cultures with Amlodipine () (0.1-10 micromol/l) significantly enhanced the basal NO formation in a concentration-dependent manner which was abrogated in the presence of L-NMMA (0.1 mmol/l). In EA.hy 926 endothelial cells, Amlodipine () treatment for 24 h significantly increased the endothelial NO synthase protein expression.

Results show that that Amlodipine () increases the endothelial NO bioavailability, firstly via enhanced NO formation and secondly by prolonging the half-life of NO through antioxidative properties. This may result in an improved endothelial function.

Amlodipine () - a cardiovascular drug with powerful antimicrobial property : Ten cardiovascular drugs were procured in pure form from their manufacturers in India and screened for antimicrobial property against fifteen known bacteria belonging to both gram-positive and gram-negative types. These bacteria were inhibited by the common antibiotics at 1-5 mg ml(-1) level through our earlier studies.

Since most of the bacteria were moderate to highly responsive to Amlodipine (), this compound was further tested in vitro against 504 bacteria comprising 4 genera of gram-positive and 15 genera of gram-negative bacteria. Most of these were inhibited by the drug at 50-200 microg ml(-1) level and few strains were sensitive even at lower concentrations (10 microg ml(-1)). Amlodipine () was found to be bactericidal in nature when its mode of action was studied against S. aureus 6571, V. cholerae 14035 and Sh boydii 8 NCTC 254/66. The antibacterial activity of Amlodipine () could also be confirmed in vivo. When it was given to Swiss strain of white mice at different dosages (30 and 60 microg/mouse), it could significantly protect the animals challenged with 50 MLD of Salmonella typhimurium NCTC 74. According to Chi square test the in vivo data were highly significant.

Amlodipine () and carvedilol prevent cytotoxicity in cortical neurons isolated from stroke-prone spontaneously hypertensive rats : In a study an analysis was conducted of the effects of antihypertensives as well as vitamin E, which were added to neuron cultures after reoxygenation (20% O2) following hypoxia (1% O2). When added after hypoxia before reoxygenation, vitamin E conferred significant protection to neuronal cells. It was also shown that vitamin E conferred complete protection from neural cell death when added hypoxia and again before reoxygenation. At higher concentrations of vitamin E, strong neuroprotection was observed.

Pretreatment with either Amlodipine (), carvedilol or dipyridamole consistently prevented cell death during hypoxia and reoxygenation (H/R). On the other hand, nilvadipine, a dihydropyridine-type calcium entry blocker, had no apparent effect on neuroprotection during H/R. The order of neuroprotective potency was vitamin E > dipyridamole > carvedilol > or = Amlodipine () > nilvadipine.

The results suggested that in our in vitro model system, antioxidants were the most important agents for the reduction of oxygen-free radical damage in cortical neurons. These findings suggest that Amlodipine () and carvedilol, with their antioxidant properties and antihypertensive activity, would be useful to inhibit neuronal cell death in the treatment of cerebrovascular stroke and neurodegenerative diseases in hypertensive patients.

 

 

 

 

 

29th August 2008