Home Drug Guide Levamlodipine Maleate

Drug Guide

Generic Name

Levamlodipine Maleate

Brand Names Conjupri

Classification

Therapeutic: Antihypertensive

Pharmacological: Calcium Channel Blocker

FDA Approved Indications

Hypertension (high blood pressure)

Mechanism of Action

Levamlodipine maleate is a racemic mixture, with the pharmacologically active S-isomer inhibiting calcium influx into vascular smooth muscle and cardiac muscle, leading to vasodilation and decreased blood pressure.

Dosage and Administration

Adult: Typically, 2.5 to 10 mg once daily, adjusted based on response.

Pediatric: Not commonly used in pediatrics; consult specific guidelines.

Geriatric: Start at lower doses due to increased sensitivity and comorbidities, monitor closely.

Renal Impairment: Adjust doses cautiously; no specific dosage adjustment, but monitor blood pressure and renal function.

Hepatic Impairment: Use with caution; start at lower doses due to reduced metabolism.

Pharmacokinetics

Absorption: Well absorbed orally, with peak plasma levels in about 6-12 hours.

Distribution: Extensively protein-bound (~97%), distributed widely.

Metabolism: Primarily hepatic via CYP3A4 to inactive metabolites.

Excretion: Excreted mainly in urine (about 60%) and feces.

Half Life: Approximately 30-50 hours, allowing for once-daily dosing.

Contraindications

Hypersensitivity to amlodipine or other dihydropyridines.
Severe aortic stenosis.

Precautions

Use cautiously in patients with congestive heart failure, liver impairment, or recent myocardial infarction. Risks of hypotension and edema should be monitored.

Adverse Reactions - Common

Peripheral edema (Common)
Flushing (Common)
Dizziness (Common)
Headache (Common)

Adverse Reactions - Serious

Hypotension (Uncommon)
Bradycardia or arrhythmia (Uncommon)
Myocardial ischemia (Rare)

Drug-Drug Interactions

Simvastatin and other CYP3A4 substrates (may increase levels)
Beta blockers (additive effects on heart rate and blood pressure)
Other antihypertensives (monitor for excessive hypotension)

Drug-Food Interactions

Grapefruit juice (may increase plasma levels)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure and heart rate regularly. Assess for signs of edema, dizziness, or adverse cardiovascular effects.

Diagnoses:

Ineffective tissue perfusion related to vasodilation leading to hypotension.
Risk for falls due to dizziness or hypotension.

Implementation: Administer consistently at the same time each day. Educate patient on monitoring blood pressure at home.

Evaluation: Evaluate reduction in blood pressure and monitor for adverse effects; adjust dosage as necessary.

Patient/Family Teaching

Take medication exactly as prescribed.
Do not abruptly stop medication.
Limit alcohol and grapefruit juice.
Report symptoms like severe dizziness, swelling, or chest pain.

Special Considerations

Black Box Warnings:

None specifically for levamlodipine.

Genetic Factors: None currently known.

Lab Test Interference: May affect laboratory assessments of liver function or kidney function.

Overdose Management

Signs/Symptoms: Severe hypotension, tachycardia or bradycardia, dizziness, and possibly shock.

Treatment: Supportive care, intravenous fluids, vasopressors for hypotension, occasionally calcium administration if indicated.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions for the duration of the shelf life.