Zanidip Dosage/Direction for Use

Posology: The recommended dosage is 10 mg orally once a day at least 15 minutes before meals; the dose may be increased to 20 mg depending on the individual patient's response.
Dose titration should be gradual, because it may take about 2 weeks before the maximal antihypertensive effect is apparent.
Some individuals, not adequately controlled on a single antihypertensive agent may benefit from the addition of Zanidip to therapy with a beta-adrenoceptor blocking drug (atenolol), a diuretic (hydrochlorothiazide) or an angiotensin converting enzyme inhibitor (captopril or enalapril).
Since the dose-response curve is steep with a plateau at doses between 20-30 mg, it is unlikely that efficacy will be improved by higher doses; whereas side effects may increase.
In severe hypertension, the dose titration period should be reduced.
Elderly patients: Although the pharmacokinetic data and clinical experience suggest that no adjustment of the daily dosage is required, special care should be exercised when initiating treatment in the elderly.
Paediatric population: The safety and efficacy of Zanidip in children aged up to 18 years have not been established. No data are available.
Patients with renal or hepatic impairment: Special care should be exercised when treatment is commenced in patients with mild to moderate renal or hepatic dysfunction. Although the usually recommended dose schedule may be tolerated by theses subgroups, an increase in the dose to 20 mg daily must be approached with caution. The antihypertensive effect may be enhanced in patients with hepatic impairment and consequently an adjustment of the dosage should be considered.
Zanidip is contraindicated in patients with severe hepatic impairment or in patients with severe renal impairment (GFR <30 ml/min), including patients undergoing dialysis (see Contraindications and Precautions).
Method of administration: Precautions to be taken before handling or administering the medicinal product: Treatment should be preferably administered in the morning at least 15 minutes before breakfast.
This product should not been administered with grapefruit juice (see Contraindications and Interactions).