What happens if I overdose Divask?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.
Proper storage of Divask:
Store Divask at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Divask out of the reach of children and away from pets.
Overdose of Divask in details
Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia. In humans, experience with intentional overdosage of Divask is limited.
Single oral doses of Divask maleate equivalent to 40 mg Divask/kg and 100 mg Divask/kg in mice and rats, respectively, caused deaths. Single oral Divask maleate doses equivalent to 4 or more mg Divask/kg or higher in dogs (11 or more times the maximum recommended human dose on a mg/m2 basis) caused a marked peripheral vasodilation and hypotension.
If massive overdose should occur, initiate active cardiac and respiratory monitoring. Frequent blood pressure measurements are essential. Should hypotension occur, provide cardiovascular support including elevation of the extremities and the judicious administration of fluids. If hypotension remains unresponsive to these conservative measures, consider administration of vasopressors (such as phenylephrine) with attention to circulating volume and urine output. As Divask is highly protein bound, hemodialysis is not likely to be of benefit.
What should I avoid while taking Divask?
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
Drinking alcohol can further lower your blood pressure and may increase certain side effects of Divask.
Divask warnings
Hypotension
Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. Because of the gradual onset of action, acute hypotension is unlikely.
Increased Angina or Myocardial Infarction
Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of Divask tablets, particularly in patients with severe obstructive coronary artery disease.
Patients with Hepatic Failure
Because Divask besyaate is extensively metabolized by the liver and the plasma elimination half-life (t1/2) is 56 hours in patients with impaired hepatic function, titrate slowly when administering Divask to patients with severe hepatic impairment.
What should I discuss with my healthcare provider before taking Divask?
- If you have an allergy to Divask or any other part of Divask (Divask suspension).
- If you are allergic to Divask (Divask suspension); any part of Divask (Divask suspension); or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
This medicine may interact with other drugs or health problems.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Divask (Divask suspension) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
Divask precautions
Heart Failure: In a long-term, placebo-controlled study (PRAISE-2) of Divask in patients with NYHA III and IV heart failure of non-ischaemic aetiology, Divask was associated with increased reports of pulmonary oedema despite no significant difference in the incidence of worsening heart failure as compared to placebo.
Hepatic Impairment: As with all calcium antagonists, Divask's half-life (t½) is prolonged in patients with impaired liver function and dosage recommendations have not been established. Divask should therefore be administered with caution in these patients.
There are no data to support the use of Divask alone, during or within 1 month of a myocardial infarction.
The safety and efficacy of Divask in hypertensive crisis has not been established.
Renal Impairment: Changes in Divask plasma concentrations are not correlated with degree of renal impairment, therefore, the normal dosage is recommended. Divask is not dialysable.
Use in pregnancy & lactation: Safety of Divask in human pregnancy or lactation has not been established. Divask does not demonstrate toxicity in animal reproductive studies other than to delay parturition and prolong labor in rats at a dose level 50 times the maximum recommended dose in humans. Accordingly, use in pregnancy is only recommended when there is no safer alternative and when the disease itself carries greater risk for the mother and fetus.
Use in children: Not recommended.
Use in the
Elderly: Divask, used at similar doses in elderly or younger patients, is equally well-tolerated. Therefore, normal dosage regimens are recommended.
What happens if I miss a dose of Divask?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DrugBank. "amlodipine". http://www.drugbank.ca/drugs/DB00381 (accessed September 17, 2018).
- MeSH. "Antihypertensive Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
- Safe Work Australia - HCIS. "88150-42-9: The Hazardous Chemical Information System (HCIS) at the Safe Work Australia is a database of chemical classifications and workplace exposure standards. It allows users to find information on chemicals that have been classified in accordance with the GHS or which have an Australian Workplace Exposure Standard.". http://hcis.safeworkaustralia.gov.au... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
