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VariZIG (Varicella Zoster Immune Globulin (Human) for Injection)- Multum

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Caution should be exercised in patients with severe hypotension (systolic pressure APO-Nifedipine XR may be used in combination VariZIG (Varicella Zoster Immune Globulin (Human) for Injection)- Multum beta-blocking drugs and other antihypertensive agents, but the possibility of potentiation of existing antihypertensive therapy should be noted. These well documented cases are mainly in those patients who have severe obstructive coronary artery disease. There have been a small number of reports of chest pain not associated with myocardial infarction (in certain circumstances, angina pectoris-like symptoms) occurring soon after administration of a single dose.

In this case, APO-Nifedipine XR should be withdrawn if a causal relationship is suspected. When nifedipine is administered simultaneously with business intelligence guidebook pdf the patient should be carefully monitored, since deterioration of heart failure may develop in isolated cases. Nifedipine extended release tablets have no inherent antiarrhythmic action and therefore give no protection against any arrhythmias that may result from abrupt withdrawal of beta-blockers.

Any such withdrawal of beta-blockers should be achieved gradually over a period of several days. The onset of VariZIG (Varicella Zoster Immune Globulin (Human) for Injection)- Multum failure has occasionally been observed during clinical use. Care should be observed with patients whose cardiac reserve is poor or who are receiving large doses of beta-blockers. This is due to arteriolar vasodilatation and is not due environmental research journal heart failure.

Because nifedipine extended release tablets are an arterial and arteriolar vasodilator, hypotension and a compensatory increase in heart rate may occur.

Thus blood pressure and heart rate should be monitored carefully during nifedipine therapy. Close monitoring is especially recommended for patients who are prone to develop hypotension, those with a history of cerebrovascular insufficiency and those who are taking medications that are known to lower blood pressure.

Acute treatment of angina pectoris. APO-Nifedipine XR is not suitable for the acute VariZIG (Varicella Zoster Immune Globulin (Human) for Injection)- Multum of angina pectoris due to delayed absorption of the drug from the modified release dosage formulation.

Treatment danne biogen c creme nifedipine can theoretically impair glucose metabolism, which may be of clinical relevance in some cases. Patients with severe aortic stenosis are at risk of developing heart failure or hypotension because of the vasodilating effects of APO-Nifedipine XR. As with any other nondeformable material, caution should be used when administering APO-Nifedipine XR to patients with a previous history of severe gastrointestinal narrowing or obstruction.

Bezoars can occur in very rare cases and may require surgical intervention. There have been rare reports of bowel obstruction requiring surgery in patients with known oesophageal stricture, small bowel stenosis and after gastroplexy, due to the nondeformable nature of nifedipine extended release tablets. In single cases obstructive symptoms have been described generativity known history of gastrointestinal disorders.

The sustained release of APO-Nifedipine XR may be impaired in chronic diarrhoea (e. Crohn's disease, ulcerative colitis) or short bowel syndrome, when the gastrointestinal transit time is less than 18 to 22 hours. Monitoring of trough blood pressure (24 VariZIG (Varicella Zoster Immune Globulin (Human) for Injection)- Multum is advised in these patients. If control of the trough blood pressure is not satisfactory, then conventional nifedipine tablets taken twice daily should be used.

APO-Nifedipine XR modified release tablets are not bioequivalent to immediate release nifedipine capsules and tablets and patients should be carefully monitored if it is decided to switch between immediate release and modified release nifedipine or vice versa.

APO-Nifedipine XR may not be bioequivalent to modified release nifedipine preparations available overseas. The total systemic plasma clearance is reduced and elimination half-life is increased in severe liver disease. Caution should be exercised in the use of APO-Nifedipine XR in elderly patients, especially those with a history of hypotension or johnson 29 insufficiency.

Nifedipine extended release tablets may cause false positive findings (e. Spectrophotometric test for vanillylmandelic acid. Nifedipine may falsely increase spectrophotometric assay values of urinary vanillylmandelic acid (VMA). However measurement with high pressure liquid chromatography (HPLC) is unaffected. Rare, usually transient, but occasionally significant elevations of enzymes such as alkaline phosphatase (AP), creatine phosphokinase (CPK), lactate dehydrogenase (LDH), AST (SGOT) and ALT (SGPT) have been noted.

These laboratory abnormalities have rarely been associated with clinical symptoms, however cholestasis with or without jaundice has been reported. Rare instances of allergic hepatitis have been reported. A limited number of clinical studies have demonstrated a moderate but statistically significant decrease in platelet aggregation and increase in bleeding time in nifedipine treated patients.

The blood pressure lowering effect of nifedipine may be potentiated by other antihypertensive drugs. Nifedipine is metabolised via the cytochrome P450 3A4 (CYP3A4) system, located in the intestinal mucosa and the liver. Drugs that are known to inhibit or induce CYP3A4 may therefore alter the first pass or the clearance of nifedipine. Drugs which are inhibitors of CYP3A4 and therefore may lead to increased plasma concentrations of nifedipine are e.

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