Cardiplot Special Precautions

Should be administered with caution in patients with mild hepatic impairment, since the antihypertensive effect may be increased (see Dosage & Administration).
A reduction of the dose is required in elderly patients due to the slowing down of the metabolic processes (see Dosage & Administration).
Manidipine should be administered with caution in patients with left ventricular failure, in patients who have left ventricular outflow tract obstruction, isolated right heart failure or sick sinus syndrome (with no pacemaker).
Since there are no study results available on patients with stable coronary disease, caution should be taken with these patients due to the possibility of increased coronary risk (see Adverse Reactions).
Since there are no in vivo interactions study available on the inhibiting or inducing effects of CYP3A4 on the pharmacokinetics of manidipine, Cardiplot should not be administered concomitantly with cytochrome CYP3A4 inhibitors (e.g. antiprotease, cimetidine, ketoconazole, itraconazole, erythromycin, clarithromycin) and cytochrome CYP3A4 inducers (e.g. phenytoin, carbamazepine, phenobarbital, and rifampicin) (see Interactions).
Special caution should be taken in prescribing manidipine concomitantly with other substrates of CYP3A4, such as terfenadine, astemizole, quinidine and class III antiarrhythmics such as amiodarone (see Interactions).
Excipients: Cardiplot contains lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Effect on ability to drive and use machines: Since dizziness may be experienced due to a reduced blood pressure, patients should be advised to take care while driving and operating machinery.