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Amlodipine should be initiated at the lowest dose and titrated slowly in patients with severe hepatic impairment. Amlodipine is not dialysable. Hypersensitivity to dihydropyridines derivatives, amlodipine or to any of the excipients listed in section 6. Shock including cardiogenic shock, obstruction of the outflow tract of the left ventricle e. Patients with heart failure should be treated with caution. In a long-term, placebo-controlled study in patients with severe heart failure NYHA class III and IV the reported incidence of pulmonary oedema was higher in the amlodipine treated group than in the placebo group see section 5.
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