NIKP-Manidipine Special Precautions

NIKP-Manidipine tablets should be administered with care in the following patients: Patients with serious hepatic disorder [The metabolism and excretion of NIKP-Manidipine tablets may be delayed.]
Elderly patients (see Elderly under Dosage & Administration).
Important Precautions: Abrupt withdrawal of calcium antagonists has been reported to aggravate symptoms in some patients. If NIKP-Manidipine tablets are withdrawn, the dosage should be gradually reduced under close observation. In addition, the patient must be instructed not to discontinue taking NIKP-Manidipine tablets without direction by a physician.
An excessive decrease in blood pressure may occur rarely which results in symptoms such as transient loss of consciousness or cerebral infarction. If such symptoms are observed, appropriate therapeutic measures such as reducing the dose or withdrawing the drug should be taken. (See Clinically Significant Adverse Reactions under Adverse Reactions.)
Since NIKP-Manidipine tablets may induce dizziness, etc. due to its hypotensive effects, patients should be instructed to use caution when operating hazardous machinery such as working at heights or driving a car.
Other precaution: It has been reported that dialysis effluent of patients on CAPD (continuous ambulatory peritoneal dialysis) may become cloudy and lipid (e.g. triglyceride) levels in dialysis effluent increased. Pay attention to making the distinction from peritonitis, etc.