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Car Valet the Easy Way near Methil
Everything has been changed in the new normal and so should be getting your car detailed around Methil. Gone are the days of worrying about setting up appointments and making sure the work gets done right. Oh, and the queues, the endless queues!
Wash.GT allows you to get all that work done from your smartphone, no matter where you may be around Fife. Our platform allows you to get your car detailed just as easy as ordering food or booking a ride from your phone. Always have the best options available in Methil to get the job done without all the hassle you were used to facing.
Let's look at a few ways how Wash.GT makes having your car valeted much easier.
Match Your Schedule To Have Your Car Detailed
A very irritating part of getting your car washed is finding a professional who will do it when it's convenient for you around Methil. That is not a problem on Wash.GT as you can set an appointment for the time that suits you best. The car detailing professionals will match the job to your schedule and get it done when and where you would prefer. You will never have to clear up your schedule ever again to get your car valeted, just find what time is best for you and set an appointment on Wash.GT. Changes in plans either on your end of the professionals are also managed seamlessly through Wash.GT application.
Local Car Detail Professionals
Due to the hectic day to day routine, everyone faces these days, no one is even aware of the services available in Methil and Fife. Instead of going on a tiring search or having to ask someone else, you can get all the best car detailing professionals in your area on Wash.GT. Hiring people in Methil lets you have a better deal on the price of the services instead of having someone come in from outside Fife. Wash.GT matches you up with just the best people to valet your car that will be with you as soon as possible. Make good use of all the talented professionals in Methil and Fife.
Car Detail Progress Reports
Car detailing takes some time and has a bunch of different steps that need to be taken care of. Everyone likes to make sure that the steps are done properly but no one likes to hover on their car while it's getting cleaned. Wash.GT gives you the option to monitor the progress of work in real-time at your Methil location. You will know exactly how much work is done and how much of it is left at any time during the job is being done. If you would like to see a certain portion of the job get done yourself, you can check through Wash. GT application when it's being done and go to your car.
Car Detail Live Map Location
Once you find the right guy to wash your car, the next difficult thing is guiding them to its exact Methil location. Wash.GT has a map feature and GPS built into the application that lets the professionals come straight to your car around Fife and get the job done. With Wash.GT, you will never have to waste hours on the phone trying to help the professionals find your location in Methil. This saves you much valuable time and relieves you of all that unnecessary stress. Once the time of your appointment comes up, the professionals get the directions to your location and get there hassle-free.
Car Detailing near Methil
Get precious hours back and save yourself the hassle of valeting your car with our app.
Wash.GT on-demand services will revolutionise urban car care. Targeting time-starved busy customers, Wash.GT is a pure convenience-based service driven through a mobile app, giving customers a totally new and unique experience when it comes to car care. The primary focus for our App is the user experience with a clean user interface that enables a car washing service to be booked in just a few clicks.
Car Detailing App in Methil, Fife, Scotland, United Kingdom
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Car Valeting
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House votes to defuse debt limit crisis
Published 2:16 pm Wednesday, January 23, 2013
WASHINGTON — The House overwhelmingly passed a bill Wednesday to permit the government to borrow enough money to avoid a first-time default for at least four months, defusing a looming crisis setting up a springtime debate over taxes, spending and the deficit.
The House passed the measure on a bipartisan 285-144 vote as majority Republicans back away from their previous demand that any increase in the government's borrowing cap be paired with an equivalent level of spending cuts.
Senate Majority Leader Harry Reid, D-Nev., said the chamber would immediately move to advance the legislation to the White House, which has announced Obama would sign it.
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The measure would suspend the $16.4 trillion cap on federal borrowing and reset it on May 19 to reflect the additional borrowing required between the date the bill becomes law and then. The amount of borrowing required depends on the tax receipts received during filing season, but over a comparable period last year the government ran deficits in the range of $150 billion.
The measure also contains a provision that slaps at the Senate, which hasn't debated a budget since 2009, by withholding the pay for either House or Senate members if the chamber in which they serve fails to pass a budget plan. Sen. Patty Murray, D-Wash., announced Wednesday that the chamber would indeed debate a budget this year but maintained the GOP's "no budget, no pay" move had nothing to do with the decision.
President Barack Obama vows not to negotiate over the debt ceiling as he did in the summer of 2011, though he promises further action on the budget. Wednesday's developments mark a shift of the budget debate away from failed head-to-head talks between Obama and Boehner
The idea driving the move by GOP leaders like Speaker John Boehner, R-Ohio, is to re-sequence a series of upcoming budget battles, taking the threat of a potentially devastating government default off the table and instead setting up a clash in March over automatic across-the-board spending cuts set to strike the Pentagon and many domestic programs. Those cuts — postponed by the recent "fiscal cliff" deal — are the punishment for the failure of a 2011 congressional deficit-reduction supercommittee to reach an agreement.
This "no budget, no pay" idea had previously been regarded by many as a gimmick but has been given new life by Boehner as a "reform" to pair with an increase in the so-called debt limit. Boehner previously had insisted that any increase in borrowing authority to avoid lapses in payments to contractors, unemployment benefits or Social Security checks — and possibly even interest payments on U.S. Treasury obligations — be matched dollar for dollar with spending cuts. Many Republican speakers preferred to focus on the pay provision.
"This is not a gimmick," said Rep. Michael Fitzpatrick, R-Pa. "For the past almost going on now four years, our colleagues in the Senate have failed in their most basic responsibility of governance, which is to pass a budget."
"All we're saying is 'Congress follow the law. Do your work. Budget,'" said House Budget Committee Chairman Paul Ryan, R-Wis. "And the reason for this (debt) extension is so that we can have the (budget) debate we need to have."
Boehner promises that the GOP blueprint will project a balanced budget at the end of a 10-year window.
"Balancing the budget over the next 10 years means that we save the future for our kids and our grandkids," Boehner said. "It also means that we strengthen programs like Social Security and Medicare and Medicaid that can't continue to exist in their current form without some kind of controls."
But the White House weighed in Tuesday with a statement that the administration would not oppose the debt measure, even though Obama just last week dismissed incremental increases in the debt ceiling as harmful to the economy.
It also appeared virtually certain that Senate Democrats would accept the bill even though they would prefer a longer-term solution to the debt issue and believe that the "no budget, no pay" provision is silly.
While the measure permits an undetermined amount of additional borrowing through May 18, the actual date in which the government might be at risk of defaulting on its obligations would be several weeks later. That's because the government would retain the ability to juggle its books through what the Treasury Department calls "extraordinary measures."
With the debt battle averted, the next fight comes in March over across-the-board cuts that would pare $85 billion from this year's budget. They were delayed from Jan. 1 until March 1 and reduced by $24 billion by the recently enacted tax bill. Defense hawks are particularly upset, saying the Pentagon cuts would devastate military readiness and cause havoc in defense contracting. The cuts, called a sequester in Washington-speak, were never intended to take effect but were instead aimed at driving the two sides to a large budget bargain in order to avoid them.
But Republicans and Obama now appear on a collision course over how to replace the across-the-board cuts. Obama and his Democratic allies insist that additional revenues be part of the solution; Republicans say further tax increases are off the table after the 10-year, $600 billion-plus increase in taxes on wealthier earners forced upon Republicans by Obama earlier this month.
"We are not going to raise taxes on the American people," Boehner told reporters Tuesday.
According to the latest calculations, which account for the recent reduction of this year's sequester from $109 billion to $85 billion, the Pentagon now faces a 7.3 percent across-the-board cut, while domestic agency budgets would absorb a 5.1 percent cut. The calculations are not official but were released Tuesday by Richard Kogan, a budget expert with the Center on Budget and Policy Priorities think tank.

subset: commoncrawl


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Czech Seedbead 10/0 Opaque Pearl White 20g
- Category: All Beads, Czech Beads, Czech Seedbead 10/0
Preciosa Czech Seedbead
10/0 Opaque Pearl White
20 gram bag
Preciosa Czech Seedbead
10/0 Opaque Pearl White
20 gram bag
How long will my order take to be shipped?
We take about 1-2 days to pack your order. You will receive a shipping confirmation once its packed. Due to being in a Northern community, our mail only leaves Wednesday and Friday.
Once your order has shipped, we have no control on how long it takes for you to receive your package.
If you are placing a special order, this may take about 1-2 months.
Do you have a budget-friendly shipping option?
We do offer $6.00 CAD Untracked & Uninsured lettermail/oversized mail option for items under 300 grams. Please write in the comments before placing your order "Untracked & Uninsured". We will refund you the difference.
Do you accept email money transfers?
If you feel more comfortable with EMT's, we can totally do that for you. Our account is set up for auto-deposit. If your bank requires a password, please use the password "cvltvrebead".
Do you ship internationally?
We do ship internationally. Wherever Canada Post ships, your package can be delivered. You may lose tracking your package once it leaves Canada. Depending on the order size, you may have to pay for customs, which we are not responsible for.
Do you accept large orders?
This is more open for teachers, entities, and schools. Artists that use a lot of beads for large projects will be considered also. We can place large orders for you. If we do not have enough supplies in-store, we will have to place a special order. Please email us and we will gladly help you.


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Teriyaki Town
- 5605 112Th St E # 100
- Puyallup, WA 98373
- (253) 445-2443
Travel Tacoma - Mt. Rainier cookies policy
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funny animals blogurl:johnkstuff.blogspot.com
If I sent a one page outline of a story idea to a network executive, I'd get back 10 pages of retarded notes telling me to ruin every creative thought and make all the drawings bland and ugly and make the story not make any sense.
Kyle's only note for the video was "make me sexy" which was a completely reasonable request and easy to fulfill.
Rock Stars seem to understand that creative stuff is a treat and you should leave creative people alone to make their ice cream. Executives want to mix in poo and cigarette butts with your ice cream.
So if you ever see Jack or any other rock stars who like funny cartoons, give them a big sloppy kiss (or give 'em your sister).
And who absolutely shouldn't be animation executives?
actual size
Find out in the most offensive article ever written about animation!


text: by David Crane david at defensereview.com Last year, DefenseReview received some interesting (and disturbing) video footage of an Edinburgh Risk and Security Management (ERSM) PSD/Security Operator team getting ambushed by Iraqi insurgents/terrorists in Baghdad, Iraq, while conducting Operation APOLLO. The contact occurred on the morning of April 20, 2005 (4/20/2005) on the infamous BIAP Road. This was a small arms contact. The enemy was …Read More »


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- Dominant milf beauty chokes her submissive 06:07 5119 views
PeggingVids.com is only for Adults. PeggingVids has the best free strapon pegging porn videos, strapon sex videos, pegging video compilations and more adult videos. All models are at least 18 years of age or older. 0 videos are hosted on our server.


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WASHINGTON, Mass. — A young man was killed early Saturday morning, June 26, in a single-car crash on Blotz Road.
State police say Chad Beeler, 26, was operating a 1989 Ford Mustang eastbound on Blotz Road when the car went off the road and rolled over, partially ejecting Beeler.
The crash was reported at 5:38 a.m. and troopers assigned to the Cheshire barracks responded to the scene. Beeler was fatally injured and pronounced dead at the scene. No further information was immediately available.
The preliminary investigation was done by Trooper Hanna Harbour and the circumstances of the crash remain under investigation by Troop B, with the assistance of the Collision Analysis
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This is a Standard Bank Repossessed Property. Standard Bank uses your Pre-auction offer to determine which properties go on auction next. All online bids and Pre-Auction offers on Standard Bank's Repossessed properties must be logged on this system. Email any queries to email@example.com .
The steps involved in buying a repossessed property on online auction is similar to that of buying any other property at an auction. If your bid is found to be successful at the end of the auction after the auction closed, you will receive an email to notify you, which will contain the Conditions of Sale contract as well as instructions to pay your 10% (or more) deposit. At this stage you will have 48 hours to pay your cash deposit in order for Standard Bank to proceed with the transaction. Once your deposit is paid Standard Bank will require you to complete and sign the Conditions of Sale contract and fax to 086 517 0269 along with a certified copy of your ID book as well as proof of residential address (water and electricity bill). If you require finance for this property, you can apply at any bank for a bond, as you would do on any other property. You need to take the signed Conditions of Sale contract to them with the application documentation. Please take note that according to CPA regulations obtaining finance can not be a suspensive clause in the contract. Read Standard Bank frequently asked questions for more info about Standard Bank Repossessed Property
Standard Bank Disclaimer
This list is produced by the Standard Bank of South Africa Ltd ("the Bank") for information purposes only. All properties are sold "voetstoots" (meaning as is), and prospective purchasers' are advised that the Bank does not guarantee vacant occupation of the properties being sold, and purchasers will have to obtain vacant occupation at their own cost. You are advised to consult the relevant Deeds Registry Office for accurate information pertaining to a particular property, such as size, endorsements, servitudes etc. By making an offer on any property advertised on MyRoof.co.za, online, or using any other medium you warrant that you understand that making an offer is not a binding process and Standard Bank, in its sole and unbiased discretion, and for whatever reason retains the right to accept or reject any offer at any time for whatever reason and is not obliged to accept the highest offer. All users of the information on this website do so at their own risk. Neither the Bank nor MyRoof.co.za will be liable for any losses of whatsoever nature incurred, as a direct or indirect result of the use of the information on this list.
Standard Bank recommends that potential purchasers visit(s) and inspect(s) each property prior to submitting a bid via the online auctioneering platform to ensure that potential purchasers familiarize themselves with the condition of the property, prior to submitting a bid. If potential purchaser(s) are not able to view and inspect the property, Standard Bank advises potential purchaser(s) to refrain from participating in the bidding process.
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By David Crane defrev (at) gmail (dot) com January 12, 2010 DefenseReview recently published an article on the GEN II SRSS BullDog762 bullpup M14/M1A 7.62mm NATO battle rifle going to combat in Stan (Afghanistan), and we're currently waiting on a field report on it. In the meantime, Short Rifle Stock Systems Inc. (SRSS) has just released a short test/demonstration video …Read More »
Tag Archives: srss
SRSS BullDog762 Bullpup M14/M1A 7.62mm Battle Rifle Goes to Combat: SpecOps Tests BullDog's Bite
By David Crane defrev (at) gmail (dot) com November 29, 2009 Updated on 12/04/09 Fourteen months ago, DefenseReview broke the story on the SRSS BullDog762 bullpup M14/M1A battle rifle (7.62x51mm NATO/.308 Win.). Well, the BullDog 762 just went operational, and Defense Review is going to keep an eye on it to see how it performs in the U.S. military Special …Read More »
SRSS BullDog762 Bullpup M14/M1A Battle Rifle (7.62mm NATO/.308 Win.) Range Session
By David Crane defrev at gmail dot com September 22, 2008 All photographic images contained in this article were taken by DefenseReview.com, and are the exclusive property of DefenseReview.com. DefenseReview.com owns the copyright on these photos. All photos were shot with an Olympus Stylus 790 SW 7.1-megapixel digital camera, which is advertised as "shock + waterproof". On August 30th, 2008, …Read More »


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A rainy day in Manhattan. Times Sq. December 9, 2012. Outside the Marquis-Marriott. Found what I came for, stalwart defenders of Democracy, real Democracy, not the Marxist-Sharia charades.
And, of course, tourists. Lots of tourists at 46th and Broadway. A location the Leftists love. They hang here often, spewing their anti-Israel and anti- American messages. Great to see a different, more positive message reach out to the tourists for a change.
Vendors, halal carts, buskers dressed as cartoon characters filled the sidewalks as these young defenders of Democracy stood quietly in front of the Evita sign. Too quietly…. Standing quietly in NY, just doesn't get you noticed.
If only they had a bit of the Leftist moxie. The passers-by needed to be engaged, sharing specifics the banner didn't offer. A web-site, maybe. Or just thoughts on how someone could join their movement. Talking….one on one….about democracy to those walking by and what it means to them….
Unfortunately, there was no way of knowing whether they were college Leftists, Union shills or MSA-CAIR front-groups pretending to support Western values.
The Leftists seem to have no problem when it comes to preaching their dogma. On November 21, a few NYC-Commies, led by 20-something Caleb Maupin, were protesting the remake of "Red Dawn". They confidently preached their garbage to the passersby.You knew why they were there (in support of the murderous NoKo Regime)
And very definitely knew who they represented (Workers World Party.)
I don't admire them. Just observing….The Left is very adept at enticing the gullible public with buzz-words that mask their real goals.
Hope the rally I saw today in support of REAL Democracy, will be able to find its voice. Not by trickery, just by the force of confidence. Their message on-line is a good beginning….
From their Face Book Page.
People of all religions, ethnicities & countries are called upon to join forces to Support Freedom & Democracy – Confront Evil
We thank America for Supporting Freedom, Democracy and Self- Determination of many countries around the world. America will confront new challenges & evils in every generation – May it continue to be Land of the Free & Home of the Brave!
We recognize Tibets right to Freedom, Democracy and self determination. America should help Tibetans in their efforts.
We recognize South Sudans right to Freedom, Democracy & Self Determination and congratulate them on Independence.
We recognize Israels quest for peace and right to defend themselves against Islamic extremism.
We recognize and appreciate American & Canadian efforts to Promote Freedom & Democracy around the world.
We recognize the Armenian Genocide and call on Governments and World parliaments to recognize past atrocities and support Armania's quest for Freedom & Democracy.
I hope they didn't leave discouraged. God-Speed to them as they learn how to fight for what is right!


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Tuesday August 6th, 1940
Tuesday August 6th, 1940
August Sixth, Nineteen Forty
August Sixth, Nineteen Forty
How old am I if I was born on August 6, 1940?
Date Facts:
If you were born on this date:
Page Contents:
Related Pages:
Most popular baby names of 1940 ranked:
Celebrities Birthdays:
August 6th
You Share a birthday with over 17 other celebrities and/or famous people! Click Here to view our complete list. Who do you share a birthday with?
Peridot: Birthstone for August 6th, 1940
Click Here To learn more about August Birthstones
Peridot, the birthstone of August, is a soft, lime green gem stone. Often associated with peace, good fortune and happiness, this gemstone primarily come from Egypt and was often worn by the ancient Pharaohs. Also know as the 'Gem of the sun', the Peridot makes for an ideal 16th anniversary gift and for good reason. With the ability to ward off Evil and nightmares, while also bestowing peace, loyalty, and commitment to ones love life.
Traditionally a lime green color, the Peridot mixes very well with platinum's and silvers. The stone belongs to the Forsterite-Fayalite mineral group, which means its color comes from the composition of the mineral itself as opposed to impurities in which more other stones acquire their color. Due to this, the stone is purely one color, and only varies with slightly different shades of green, and sometime with a hint of yellow.
1940 - the Silent Generation:
Age Range:
79-100 years old
The silent Gen were born into a fortunate time period associated with wealth, and high eduaction.
the Silent Generation Summary:
Contrary to their name, the Silent Generation tended to be very patriotic and ambitious. They were plagued with the Korean war, and economic instability following WWII
Time Period:
You are part of the Silent Generation
Like to see more about Generations? Click here to go to our interactive generations table.
Zodiac - Leo:
Leo Traits:
Leo Summary:
Leos are generous and kind, yetis also known for having a s short and hot temper
Start Date:7-23
End Date:8-22
Click here to see more about Leo
August 6th, on this day in History:
1940-08-06: This day in History:
8-6-1940 in
Roman Numerals:
What is 1940-08-06 converted to roman numerals? Above is the date 8-6-1940 converted into roman numerals.
The above date is written in the traditional western/American style of writing dates. Formatted in the order of
Month-Day-Year. If you prefer the European way of writing dates (Which is day-month-year) the roman numerals would be written VI • VIII • MCMXL.
Next Birthday Countdown:
Countdown timer for Aug 6, 2024:
Click to see age and birthday countdown timer
The above timer is a countdown clock for your next birthday! (Assuming you were born on 1940-08-06) This timer is automatically updated, and is accurate all the way up to the nearest second. Watch as your next birthday ticks closer and closer right before your eyes. If you were born on august-6th-1940, your next birthday is only 243 days away.
Your birthday is on August sixth, 1940. Being born in early-August says a lot about you. Your zodiac sign is leo, your birth-stone is the Peridot, and your birth flower is the Gladiolus (both of which make great gifts for someone with this birthday). You are 83 years old, and were born in the middle of the Silent Generation. Which generation you are born into makes a huge impact on your life, click here to see our interactive table and learn more. You have been alive for 30438 days, or 730512 hours, or 43830720 minutes! Your next birthday which is in 2024, is on a Tuesday.


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Rate Chevrolet of South Anchorage
Here at Chevrolet of South Anchorage, we believe that customer feedback is a valuable resource and we welcome your comments.
Please click one of the links below to write a review, or visit our store located at 9100 OLD SEWARD HWY ANCHORAGE, AK to let us know how we are doing.
Thank you for taking the time to share your experience. We look forward to serving you in the future.
*GOOGLE is a trademark of Google Inc. Yelp logo and related marks are registered trademarks of Yelp. All rights reserved. DealerRater is a trademark of DealerRater.com, LLC. Cars.com is a trademark of Cars.com. Edmunds logo and related marks are registered trademarks of Edmunds.


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Opertray Division
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Plainst Technologies, one of the medical industry's leaders in nanotechnologies, desired an online display of their strategy to increase site sales, while utilizing their current customer base.
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A dynamically innovative digital media suite that allows users to be retargeted based on the tour they saw last and spent the most time viewing. This was done by introducing a contextual campaign to increase reach by showing prospective audiences the current, and most popular tour. In addition to that, we applied daily and lifetime frequency caps specific to each user in order to prevent overexposure.
We've achieved a Click Through Rate (CTR) of 0.09%, which generated a number of new sales. In the campaign's inaugural month of activity the Cost Per Action (CPA) was reduced by 20%, surpassing the client's target. February 2013 saw post-click revenue – (generated by both dynamic retargeting and the prospecting campaign) – produce a Return on Investment (ROI) of 272%.
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From The Client
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Super cute clothes and great quality. Fast delivery time. Very positive experience. Thank you! I give curvaceous apparel a 5 star.
I got my order! I love my new summer pajamas!!! The products are well made!! The material is very smooth, exactly as the picture shows!!
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Hyun-Jin Ryu (14-7, 2.97) vs. Jeff Francis (2-5, 6.61).
With Clayton Kershaw getting his proper tuneup and Zack Greinke right behind Kershaw in sharpness, today we let Ryu take the mound and bring this season to a close.
Today is also the Dodgers' Fan Appreciation Day, which means all fans in attendance are eligible for outstanding prices like a Hello Kitty Themed Party at Your Home for 20. Hold on a second, is this Fan Punishment Day? (Actually, there are some cool prizes (including a Vin Scully outgoing voicemail message!); full prize list details here.) Following the game, there's a postseason rally hosted by Arsenio Hall.
The Rockies wanted to start Tyler Chatwood in their final 2013 game, since Francis hasn't started since June 18. However, Chatwood is dealing with right elbow soreness, so Francis gets the nod. Or, in other words, the guy that's restin' ain't Francis.
Thank you, Rancho Cucamonga! Good night!
UPDATE 10:28a: There's also a bevy of games going on this morning with playoff and/or playoff pairing implications: Rays @ Blue Jays, Phillies @ Braves; Indians @ Twins, Cubs @ Cardinals, and Angels @ Rangers: all of which have first pitches prior to 1p PT. Please feel free to make this a Scoreboard Watching thread as well!


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DND DC 140 Khaki Rose - DND DC Gel Polish & Matching Nail Lacquer Duo Set
With the new formula, DND DC represents a premium gel polish with superior pigmentation and coverage. DC Gel polish lasts up to 21 days without chipping or peeling. Easily soak off within 10 to 15 minutes. LED and UV cured.
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Made in the USA.
Product Name: 140 Khaki Rose
Color: Beige
Size: 0.6 oz
Brand: DND
Collection: DND DC Gel & Lacquer Duo
Type: Gel & Lacquer
Features: Gel & Lacquer
Condition: New Item
Weight: 145 grams - (0.32 lb)
PLEASE NOTE: Color samples/ images may vary depending on different monitors and screens. It is up to the buyer to do their research for the product they are purchasing. Packaging may vary.


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You can read detailed information about the use of cookies on cl.ipc2u.com here as well as manage the cookie settings.
By using this website you agree to the use of cookies.
|Solicitar información por precio
1xPICMG, 1xPCI-Express x16, 4xPCI-Express x1, 3xPCI Slots PICMG 1.3 Passive Backplane
PesoPeso bruto: 0.4 kg


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- About this app
This app was created to use the Twitter API
- Privacy Policy
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- Mute, block, and report accounts for you.
- See your email address.
Learn more about third-party app permissions in the Help Center.


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Metallica And Justice For All Tee - Little Kid / Big Kid - Black
Point the camera at your feet to see the shoes!
Point the camera at your feet to see the shoes!
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Videos for #10511 Firestorm 10T
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Label: AMLODIPINE BESYLATE tablet
- NDC Code(s): 61919-782-30
- Packager: Direct_Rx
- This is a repackaged label.
- Source NDC Code(s): 29300-243
- Category: HUMAN PRESCRIPTION DRUG LABEL
- DEA Schedule: None
- Marketing Status: Abbreviated New Drug Application
Drug Label Information
Updated January 17, 2020
If you are a consumer or patient please visit this version.
- Download DRUG LABEL INFO: PDF XML
- Official Label (Printer Friendly)
1.1 Hypertension
Amlodipine besylate tablets are indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including amlodipine besylate tablets.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program's Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mm Hg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
Amlodipine besylate tablets may be used alone or in combination with other antihypertensive agents.
1.2 Coronary Artery Disease (CAD)
Chronic Stable Angina
Amlodipine besylate tablets are indicated for the symptomatic treatment of chronic stable angina. Amlodipine besylate tablets may be used alone or in combination with other antianginal agents.
Vasospastic Angina (Prinzmetal's or Variant Angina)
Amlodipine besylate tablets are indicated for the treatment of confirmed or suspected vasospastic angina. Amlodipine besylate tablets may be used as monotherapy or in combination with other antianginal agents.
Angiographically Documented CAD
In patients with recently documented CAD by angiography and without heart failure or an ejection fraction <40%, amlodipine besylate tablets are indicated to reduce the risk of hospitalization for angina and to reduce the risk of a coronary revascularization procedure.
2.1 Adults
The usual initial antihypertensive oral dose of amlodipine besylate tablets are 5 mg once daily, and the maximum dose is 10 mg once daily.
Small, fragile, or elderly patients, or patients with hepatic insufficiency may be started on 2.5 mg once daily and this dose may be used when adding amlodipine besylate tablets to other antihypertensive therapy.
Adjust dosage according to blood pressure goals. In general, wait 7 to 14 days between titration steps. Titrate more rapidly, however, if clinically warranted, provided the patient is assessed frequently.
Angina: The recommended dose for chronic stable or vasospastic angina is 5–10 mg, with the lower dose suggested in the elderly and in patients with hepatic insufficiency. Most patients will require 10 mg for adequate effect.
Coronary artery disease: The recommended dose range for patients with coronary artery disease is 5–10 mg once daily. In clinical studies, the majority of patients required 10 mg [see Clinical Studies (14.4)].
2.2 Children
The effective antihypertensive oral dose in pediatric patients ages 6–17 years is 2.5 mg to 5 mg once daily. Doses in excess of 5 mg daily have not been studied in pediatric patients [see Clinical Pharmacology (12.4), Clinical Studies (14.1)].
Tablets: 2.5 mg White to off-white round flat faced bevelled edged tablets debossed with 'U' on one side and '241' on the other side.
Tablets: 5 mg White to off-white round flat faced bevelled edged tablets debossed with 'U' on one side and '242 on the other side.
Tablets: 10 mg White to off-white round flat faced bevelled edged tablets debossed with 'U' on one side and '243 on the other side
5.1 Hypotension
Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. Because of the gradual onset of action, acute hypotension is unlikely.
5.2 Increased Angina or Myocardial Infarction
Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of amlodipine, particularly in patients with severe obstructive coronary artery disease.
5.3 Patients with Hepatic Failure
Because amlodipine is extensively metabolized by the liver and the plasma elimination half-life (t 1/2) is 56 hours in patients with impaired hepatic function, titrate slowly when administering amlodipine to patients with severe hepatic impairment.
6.1 Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Amlodipine has been evaluated for safety in more than 11,000 patients in U.S. and foreign clinical trials. In general, treatment with amlodipine was well-tolerated at doses up to 10 mg daily. Most adverse reactions reported during therapy with amlodipine were of mild or moderate severity. In controlled clinical trials directly comparing amlodipine (N=1730) at doses up to 10 mg to placebo (N=1250), discontinuation of amlodipine because of adverse reactions was required in only about 1.5% of patients and was not significantly different from placebo (about 1%). The most commonly reported side effects more frequent than placebo are reflected in the table below. The incidence (%) of side effects that occurred in a dose related manner are as follows:
2.5 mg
5 mg
10 mg
Other adverse reactions that were not clearly dose related but were reported with an incidence greater than 1.0% in placebo-controlled clinical trials include the following:
Amlodipine (%)
Placebo (%)
Abdominal Pain
For several adverse experiences that appear to be drug and dose related, there was a greater incidence in women than men associated with amlodipine treatment as shown in the following table:
Male = %
The following events occurred in <1% but >0.1% of patients in controlled clinical trials or under conditions of open trials or marketing experience where a causal relationship is uncertain; they are listed to alert the physician to a possible relationship:
Cardiovascular: arrhythmia (including ventricular tachycardia and atrial fibrillation), bradycardia, chest pain, peripheral ischemia, syncope, tachycardia, vasculitis.
Central and Peripheral Nervous System: hypoesthesia, neuropathy peripheral, paresthesia, tremor, vertigo.
Gastrointestinal: anorexia, constipation, dysphagia, diarrhea, flatulence, pancreatitis, vomiting, gingival hyperplasia.
General: allergic reaction, asthenia, 1back pain, hot flushes, malaise, pain, rigors, weight gain, weight decrease.
Musculoskeletal System: arthralgia, arthrosis, muscle cramps, 1 myalgia.
Psychiatric: sexual dysfunction (male1 and female), insomnia, nervousness, depression, abnormal dreams, anxiety, depersonalization.
Respiratory System: dyspnea,1epistaxis.
Skin and Appendages: angioedema, erythema multiforme, pruritus,1 rash,1rash erythematous, rash maculopapular.
Special Senses: abnormal vision, conjunctivitis, diplopia, eye pain, tinnitus.
Urinary System: micturition frequency, micturition disorder, nocturia.
Autonomic Nervous System: dry mouth, sweating increased.
Metabolic and Nutritional: hyperglycemia, thirst.
Hemopoietic: leukopenia, purpura, thrombocytopenia.
1 These events occurred in less than 1% in placebo-controlled trials, but the incidence of these side effects was between 1% and 2% in all multiple dose studies.
Amlodipine therapy has not been associated with clinically significant changes in routine laboratory tests. No clinically relevant changes were noted in serum potassium, serum glucose, total triglycerides, total cholesterol, HDL cholesterol, uric acid, blood urea nitrogen, or creatinine.
In the CAMELOT and PREVENT studies [see Clinical Studies (14.4)], the adverse event profile was similar to that reported previously (see above), with the most common adverse event being peripheral edema.
6.2 Postmarketing Experience
Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
The following postmarketing event has been reported infrequently where a causal relationship is uncertain: gynecomastia. In postmarketing experience, jaundice and hepatic enzyme elevations (mostly consistent with cholestasis or hepatitis), in some cases severe enough to require hospitalization, have been reported in association with use of amlodipine.
Postmarketing reporting has also revealed a possible association between extrapyramidal disorder and amlodipine.
Amlodipine has been used safely in patients with chronic obstructive pulmonary disease, well-compensated congestive heart failure, coronary artery disease, peripheral vascular disease, diabetes mellitus, and abnormal lipid profiles.
7.1 Impact of Other Drugs on Amlodipine
CYP3A Inhibitors
Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is co-administered with CYP3A inhibitors to determine the need for dose adjustment [see Clinical Pharmacology (12.3)].
CYP3A Inducers
No information is available on the quantitative effects of CYP3A inducers on amlodipine. Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers.
Monitor for hypotension when sildenafil is co-administered with amlodipine [see Clinical Pharmacology (12.2)].
7.2 Impact of Amlodipine on Other Drugs
Co-administration of simvastatin with amlodipine increases the systemic exposure of simvastatin. Limit the dose of simvastatin in patients on amlodipine to 20 mg daily [see Clinical Pharmacology (12.3)].
Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. Frequent monitoring of trough blood levels of cyclosporine and tacrolimus is recommended and adjust the dose when appropriate [see Clinical Pharmacology (12.3)].
8.1 Pregnancy
Risk Summary
The limited available data based on post-marketing reports with amlodipine use in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage. There are risks to the mother and fetus associated with poorly controlled hypertension in pregnancy [see Clinical Considerations]. In animal reproduction studies, there was no evidence of adverse developmental effects when pregnant rats and rabbits were treated orally with amlodipine maleate during organogenesis at doses approximately 10 and 20-times the maximum recommended human dose (MRHD), respectively. However for rats, litter size was significantly decreased (by about 50%) and the number of intrauterine deaths was significantly increased (about 5-fold). Amlodipine has been shown to prolong both the gestation period and the duration of labor in rats at this dose [see Data].
The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2%-4% and 15%-20%, respectively.
Clinical Considerations
Disease-associated maternal and/or embryo/fetal risk
Hypertension in pregnancy increases the maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section and post-partum hemorrhage). Hypertension increases the fetal risk for intrauterine growth restriction and intrauterine death. Pregnant women with hypertension should be carefully monitored and managed accordingly.
Animal Data
No evidence of teratogenicity or other embryo/fetal toxicity was found when pregnant rats and rabbits were treated orally with amlodipine maleate at doses up to 10 mg amlodipine/kg/day (approximately 10 and 20 times the MRHD based on body surface area, respectively) during their respective periods of major organogenesis. However for rats, litter size was significantly decreased (by about 50%) and the number of intrauterine deaths was significantly increased (about 5-fold)in rats receiving amlodipine maleate at a dose equivalent to 10 mg amlodipine/kg/day for 14 days before mating and throughout mating and gestation. Amlodipine maleate has been shown to prolong both the gestation period and the duration of labor in rats at this dose.
8.2 Lactation
Risk Summary
Limited available data from a published clinical lactation study reports that amlodipine is present in human milk at an estimated median relative infant dose of 4.2%. No adverse effects of amlodipine on the breastfed infant have been observed. There is no available information on the effects of amlodipine on milk production.
8.4 Pediatric Use
Amlodipine (2.5 to 5 mg daily) is effective in lowering blood pressure in patients 6 to 17 years [see Clinical Studies (14.1)]. Effect of amlodipine on blood pressure in patients less than 6 years of age is not known.
8.5 Geriatric Use
Clinical studies of amlodipine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Elderly patients have decreased clearance of amlodipine with a resulting increase of AUC of approximately 40–60%, and a lower initial dose may be required [see Dosage and Administration (2.1)].
Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia. In humans, experience with intentional overdosage of amlodipine is limited.
Single oral doses of amlodipine maleate equivalent to 40 mg amlodipine/kg and 100 mg amlodipine/kg in mice and rats, respectively, caused deaths. Single oral amlodipine maleate doses equivalent to 4 or more mg amlodipine/kg or higher in dogs (11 or more times the maximum recommended human dose on a mg/m2basis) 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 amlodipine is highly protein bound, hemodialysis is not likely to be of benefit.
Amlodipine besylate, USP is the besylate salt of amlodipine, a long-acting calcium channel blocker.
Amlodipine besylate, USP is chemically described as 3-Ethyl-5-methyl (±)-2-[(2-aminoethoxy)methyl] 4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5-pyridinedicarboxylate, monobenzenesulphonate. Its molecular formula is C20H25ClN2O5•C6H6O3S and its structural formula is:
[Chemical Structure]
Amlodipine besylate, USP is a white crystalline powder with a molecular weight of 567.1. It is slightly soluble in water and sparingly soluble in ethanol. Amlodipine besylate Tablets, USP are formulated as white tablets equivalent to 2.5, 5, and 10 mg of amlodipine for oral administration. In addition to the active ingredient, amlodipine besylate, USP, each tablet contains the following inactive ingredients: microcrystalline cellulose, dibasic calcium phosphate anhydrous, sodium starch glycolate, and magnesium stearate.
Amlodipine besylate, USP is the besylate salt of amlodipine, a long-acting calcium channel blocker.
Amlodipine besylate, USP is chemically described as 3-Ethyl-5-methyl (±)-2-[(2-aminoethoxy)methyl] 4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5-pyridinedicarboxylate, monobenzenesulphonate. Its molecular formula is C20H25ClN2O5•C6H6O3S and its structural formula is:
[Chemical Structure]
Amlodipine besylate, USP is a white crystalline powder with a molecular weight of 567.1. It is slightly soluble in water and sparingly soluble in ethanol. Amlodipine besylate Tablets, USP are formulated as white tablets equivalent to 2.5, 5, and 10 mg of amlodipine for oral administration. In addition to the active ingredient, amlodipine besylate, USP, each tablet contains the following inactive ingredients: microcrystalline cellulose, dibasic calcium phosphate anhydrous, sodium starch glycolate, and magnesium stearate.
12.1 Mechanism of Action
Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow-channel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Experimental data suggest that amlodipine binds to both dihydropyridine and nondihydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Negative inotropic effects can be detected in vitro but such effects have not been seen in intact animals at therapeutic doses. Serum calcium concentration is not affected by amlodipine. Within the physiologic pH range, amlodipine is an ionized compound (pKa=8.6), and its kinetic interaction with the calcium channel receptor is characterized by a gradual rate of association and dissociation with the receptor binding site, resulting in a gradual onset of effect.
Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.
The precise mechanisms by which amlodipine relieves angina have not been fully delineated, but are thought to include the following:
Exertional Angina: In patients with exertional angina, amlodipine reduces the total peripheral resistance (afterload) against which the heart works and reduces the rate pressure product, and thus myocardial oxygen demand, at any given level of exercise.
Vasospastic Angina: Amlodipine has been demonstrated to block constriction and restore blood flow in coronary arteries and arterioles in response to calcium, potassium epinephrine, serotonin, and thromboxane A2 analog in experimental animal models and in human coronary vessels in vitro. This inhibition of coronary spasm is responsible for the effectiveness of amlodipine in vasospastic (Prinzmetal's or variant) angina.
12.2 Pharmacodynamics
Hemodynamics: Following administration of therapeutic doses to patients with hypertension, amlodipine produces vasodilation resulting in a reduction of supine and standing blood pressures. These decreases in blood pressure are not accompanied by a significant change in heart rate or plasma catecholamine levels with chronic dosing. Although the acute intravenous administration of amlodipine decreases arterial blood pressure and increases heart rate in hemodynamic studies of patients with chronic stable angina, chronic oral administration of amlodipine in clinical trials did not lead to clinically significant changes in heart rate or blood pressures in normotensive patients with angina.
With chronic once daily oral administration, antihypertensive effectiveness is maintained for at least 24 hours. Plasma concentrations correlate with effect in both young and elderly patients. The magnitude of reduction in blood pressure with amlodipine is also correlated with the height of pretreatment elevation; thus, individuals with moderate hypertension (diastolic pressure 105–114 mmHg) had about a 50% greater response than patients with mild hypertension (diastolic pressure 90–104 mmHg). Normotensive subjects experienced no clinically significant change in blood pressures (+1/–2 mmHg).
In hypertensive patients with normal renal function, therapeutic doses of amlodipine resulted in a decrease in renal vascular resistance and an increase in glomerular filtration rate and effective renal plasma flow without change in filtration fraction or proteinuria.
As with other calcium channel blockers, hemodynamic measurements of cardiac function at rest and during exercise (or pacing) in patients with normal ventricular function treated with amlodipine have generally demonstrated a small increase in cardiac index without significant influence on dP/dt or on left ventricular end diastolic pressure or volume. In hemodynamic studies, amlodipine has not been associated with a negative inotropic effect when administered in the therapeutic dose range to intact animals and man, even when co-administered with beta-blockers to man. Similar findings, however, have been observed in normal or well-compensated patients with heart failure with agents possessing significant negative inotropic effects.
Electrophysiologic Effects: Amlodipine does not change sinoatrial nodal function or atrioventricular conduction in intact animals or man. In patients with chronic stable angina, intravenous administration of 10 mg did not significantly alter A-H and H-V conduction and sinus node recovery time after pacing. Similar results were obtained in patients receiving amlodipine and concomitant beta-blockers. In clinical studies in which amlodipine was administered in combination with beta-blockers to patients with either hypertension or angina, no adverse effects on electrocardiographic parameters were observed. In clinical trials with angina patients alone, Amlodipine therapy did not alter electrocardiographic intervals or produce higher degrees of AV blocks.
Drug interactions
Sildenafil: When amlodipine and sildenafil were used in combination, each agent independently exerted its own blood pressure lowering effect [see Drug Interactions (7.1)].
12.3 Pharmacokinetics
After oral administration of therapeutic doses of amlodipine, absorption produces peak plasma concentrations between 6 and 12 hours. Absolute bioavailability has been estimated to be between 64 and 90%. The bioavailability of amlodipine is not altered by the presence of food.
Amlodipine is extensively (about 90%) converted to inactive metabolites via hepatic metabolism with 10% of the parent compound and 60% of the metabolites excreted in the urine. Ex vivo studies have shown that approximately 93% of the circulating drug is bound to plasma proteins in hypertensive patients. Elimination from the plasma is biphasic with a terminal elimination half-life of about 30–50 hours. Steady-state plasma levels of amlodipine are reached after 7 to 8 days of consecutive daily dosing.
The pharmacokinetics of amlodipine are not significantly influenced by renal impairment. Patients with renal failure may therefore receive the usual initial dose.
Elderly patients and patients with hepatic insufficiency have decreased clearance of amlodipine with a resulting increase in AUC of approximately 40–60%, and a lower initial dose may be required. A similar increase in AUC was observed in patients with moderate to severe heart failure.
Drug interactions
In vitro data indicate that amlodipine has no effect on the human plasma protein binding of digoxin, phenytoin, warfarin, and indomethacin.
Impact of other drugs on amlodipine
Co-administered cimetidine, magnesium-and aluminum hydroxide antacids, sildenafil, and grapefruit juice have no impact on the exposure to amlodipine.
CYP3A inhibitors: Co-administration of a 180 mg daily dose of diltiazem with 5 mg amlodipine in elderly hypertensive patients resulted in a 60% increase in amlodipine systemic exposure. Erythromycin co-administration in healthy volunteers did not significantly change amlodipine systemic exposure. However, strong inhibitors of CYP3A (e.g., itraconazole, clarithromycin) may increase the plasma concentrations of amlodipine to a greater extent [see Drug Interactions (7.1)].
Impact of amlodipine on other drugs
Amlodipine is a weak inhibitor of CYP3A and may increase exposure to CYP3A substrates.
Co-administered amlodipine does not affect the exposure to atorvastatin, digoxin, ethanol and the warfarin prothrombin response time.
Simvastatin: Co-administration of multiple doses of 10 mg of amlodipine with 80 mg simvastatin resulted in a 77% increase in exposure to simvastatin compared to simvastatin alone [see Drug Interactions (7.2)].
Cyclosporine: A prospective study in renal transplant patients (N=11) showed on an average of 40% increase in trough cyclosporine levels when concomitantly treated with amlodipine [see Drug Interactions (7.2)].
Tacrolimus: A prospective study in healthy Chinese volunteers (N=9) with CYP3A5 expressers showed a 2.5-to 4-fold increase in tacrolimus exposure when concomitantly administered with amlodipine compared to tacrolimus alone. This finding was not observed in CYP3A5 non-expressers (N= 6). However, a 3-fold increase in plasma exposure to tacrolimus in a renal transplant patient (CYP3A5 non-expresser) upon initiation of amlodipine for the treatment of post-transplant hypertension resulting in reduction of tacrolimus dose has been reported. Irrespective of the CYP3A5 genotype status, the possibility of an interaction cannot be excluded with these drugs [see Drug Interactions (7.2)].
12.4 Pediatric Patients
Sixty-two hypertensive patients aged 6 to 17 years received doses of amlodipine between 1.25 mg and 20 mg. Weight-adjusted clearance and volume of distribution were similar to values in adults.
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
Rats and mice treated with amlodipine maleate in the diet for up to two years, at concentrations calculated to provide daily dosage levels of 0.5, 1.25, and 2.5 amlodipine mg/kg/day, showed no evidence of a carcinogenic effect of the drug. For the mouse, the highest dose was, on a mg/m2 basis, similar to the maximum recommended human dose of 10 mg amlodipine/day.3 For the rat, the highest dose was, on a mg/m2 basis, about twice the maximum recommended human dose.3
Mutagenicity studies conducted with amlodipine maleate revealed no drug related effects at either the gene or chromosome level.
There was no effect on the fertility of rats treated orally with amlodipine maleate (males for 64 days and females for 14 days prior to mating) at doses up to 10 mg amlodipine/kg/day (8 times the maximum recommended human dose3 of 10 mg/day on a mg/m2 basis).
3Based on patient weight of 50 kg
14.1 Effects in Hypertension
Adult Patients
The antihypertensive efficacy of amlodipine has been demonstrated in a total of 15 double-blind, placebo-controlled, randomized studies involving 800 patients on amlodipine and 538 on placebo. Once daily administration produced statistically significant placebo-corrected reductions in supine and standing blood pressures at 24 hours postdose, averaging about 12/6 mmHg in the standing position and 13/7 mmHg in the supine position in patients with mild to moderate hypertension. Maintenance of the blood pressure effect over the 24-hour dosing interval was observed, with little difference in peak and trough effect. Tolerance was not demonstrated in patients studied for up to 1 year. The 3 parallel, fixed dose, dose response studies showed that the reduction in supine and standing blood pressures was dose-related within the recommended dosing range. Effects on diastolic pressure were similar in young and older patients. The effect on systolic pressure was greater in older patients, perhaps because of greater baseline systolic pressure. Effects were similar in black patients and in white patients.
Pediatric Patients
Two hundred sixty-eight hypertensive patients aged 6 to 17 years were randomized first to amlodipine 2.5 or 5 mg once daily for 4 weeks and then randomized again to the same dose or to placebo for another 4 weeks. Patients receiving 2.5 mg or 5 mg at the end of 8 weeks had significantly lower systolic blood pressure than those secondarily randomized to placebo. The magnitude of the treatment effect is difficult to interpret, but it is probably less than 5 mmHg systolic on the 5 mg dose and 3.3 mmHg systolic on the 2.5 mg dose. Adverse events were similar to those seen in adults.
14.2 Effects in Chronic Stable Angina
The effectiveness of 5–10 mg/day of amlodipine in exercise-induced angina has been evaluated in 8 placebo-controlled, double-blind clinical trials of up to 6 weeks duration involving 1038 patients (684 Amlodipine, 354 placebo) with chronic stable angina. In 5 of the 8 studies, significant increases in exercise time (bicycle or treadmill) were seen with the 10 mg dose. Increases in symptom-limited exercise time averaged 12.8% (63 sec) for amlodipine 10 mg, and averaged 7.9% (38 sec) for amlodipine 5 mg. Amlodipine 10 mg also increased time to 1 mm ST segment deviation in several studies and decreased angina attack rate. The sustained efficacy of amlodipine in angina patients has been demonstrated over long-term dosing. In patients with angina, there were no clinically significant reductions in blood pressures (4/1 mmHg) or changes in heart rate (+0.3 bpm).
14.3 Effects in Vasospastic Angina
In a double-blind, placebo-controlled clinical trial of 4 weeks duration in 50 patients, amlodipine therapy decreased attacks by approximately 4/week compared with a placebo decrease of approximately 1/week (p<0.01). Two of 23 amlodipine and 7 of 27 placebo patients discontinued from the study due to lack of clinical improvement.
14.4 Effects in Documented Coronary Artery Disease
In PREVENT, 825 patients with angiographically documented coronary artery disease were randomized to amlodipine (5–10 mg once daily) or placebo and followed for 3 years. Although the study did not show significance on the primary objective of change in coronary luminal diameter as assessed by quantitative coronary angiography, the data suggested a favorable outcome with respect to fewer hospitalizations for angina and revascularization procedures in patients with CAD.
CAMELOT enrolled 1318 patients with CAD recently documented by angiography, without left main coronary disease and without heart failure or an ejection fraction <40%. Patients (76% males, 89% Caucasian, 93% enrolled at US sites, 89% with a history of angina, 52% without PCI, 4% with PCI and no stent, and 44% with a stent) were randomized to double-blind treatment with either amlodipine (5–10 mg once daily) or placebo in addition to standard care that included aspirin (89%), statins (83%), beta-blockers (74%), nitroglycerin (50%), anti-coagulants (40%), and diuretics (32%), but excluded other calcium channel blockers. The mean duration of follow-up was 19 months. The primary endpoint was the time to first occurrence of one of the following events: hospitalization for angina pectoris, coronary revascularization, myocardial infarction, cardiovascular death, resuscitated cardiac arrest, hospitalization for heart failure, stroke/TIA, or peripheral vascular disease. A total of 110 (16.6%) and 151 (23.1%) first events occurred in the amlodipine and placebo groups, respectively, for a hazard ratio of 0.691 (95% CI: 0.540–0.884, p = 0.003). The primary endpoint is summarized in Figure 1 below. The outcome of this study was largely derived from the prevention of hospitalizations for angina and the prevention of revascularization procedures (see Table 1). Effects in various subgroups are shown in Figure 2.
In an angiographic substudy (n=274) conducted within CAMELOT, there was no significant difference between amlodipine and placebo on the change of atheroma volume in the coronary artery as assessed by intravascular ultrasound.
Figure 1 - Kaplan-Meier Analysis of Composite Clinical Outcomes for amlodipine versus Placebo
[Kaplan-Meier Analysis of Composite Clinical Outcomes for amlodipine versus Placebo Kaplan-Meier Analysis of Composite Clinical Outcomes for amlodipine versus Placebo Figure-02]
Figure 2 – Effects on Primary Endpoint of amlodipine versus Placebo across Sub-Groups
Table 1 below summarizes the significant composite endpoint and clinical outcomes from the composites of the primary endpoint. The other components of the primary endpoint including cardiovascular death, resuscitated cardiac arrest, myocardial infarction, hospitalization for heart failure, stroke/TIA, or peripheral vascular disease did not demonstrate a significant difference between amlodipine and placebo.
Table 1. Incidence of Significant Clinical Outcomes for CAMELOT
* Total patients with these events
Clinical outcomes
Amlodipine (N=663)
Composite CV
Hospitalization for
14.5 Studies in Patients with Heart Failure
Amlodipine has been compared to placebo in four 8–12 week studies of patients with NYHA Class II/III heart failure, involving a total of 697 patients. In these studies, there was no evidence of worsened heart failure based on measures of exercise tolerance, NYHA classification, symptoms, or left ventricular ejection fraction. In a long-term (follow-up at least 6 months, mean 13.8 months) placebo-controlled mortality/morbidity study of amlodipine 5–10 mg in 1153 patients with NYHA Classes III (n=931) or IV (n=222) heart failure on stable doses of diuretics, digoxin, and ACE inhibitors, amlodipine had no effect on the primary endpoint of the study which was the combined endpoint of all-cause mortality and cardiac morbidity (as defined by life-threatening arrhythmia, acute myocardial infarction, or hospitalization for worsened heart failure), or on NYHA classification, or symptoms of heart failure. Total combined all-cause mortality and cardiac morbidity events were 222/571 (39%) for patients on amlodipine and 246/583 (42%) for patients on placebo; the cardiac morbid events represented about 25% of the endpoints in the study.
Another study (PRAISE-2) randomized patients with NYHA Class III (80%) or IV (20%) heart failure without clinical symptoms or objective evidence of underlying ischemic disease, on stable doses of ACE inhibitors (99%), digitalis (99%), and diuretics (99%), to placebo (n=827) or amlodipine (n=827) and followed them for a mean of 33 months. There was no statistically significant difference between amlodipine and placebo in the primary endpoint of all-cause mortality (95% confidence limits from 8% reduction to 29% increase on amlodipine). With amlodipine there were more reports of pulmonary edema.
16.1 How Supplied
Amlodipine Besylate Tablets, USP 2.5mg
White to off-white round flat faced bevelled edged tablets debossed with 'U' on one side and '241' on the other side
Bottle of 90
Bottle of 300
Bottle of 500
Bottle of 1,000
Amlodipine Besylate Tablets, USP 5mg
White to off-white round flat faced bevelled edged tablets debossed with 'U' on one side and '242 on the other side
Bottle of 90
Bottle of 300
Bottle of 500
Bottle of 1,000
Amlodipine Besylate Tablets, USP 10mg
White to off-white round flat faced bevelled edged tablets debossed with 'U' on one side and '243 on the other side
Bottle of 90
Bottle of 300
Bottle of 500
Bottle of 1,000
16.2 Storage
Store at 20º to 25°C (68° to 77º F); excursions permitted between 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature] and dispense in tight, light-resistant containers.
Additional Summary of Information About leaflets can be obtained by calling Unichem at 1-866-562-4616.
Manufactured by:
Pilerne Ind. Estate, Pilerne, Bardez,
Goa 403 511, India.
Ind Area, Meerut Road, Ghaziabad – 201 003, India
Manufactured for:
[Company Logo]
Hasbrouck Heights, NJ 07604
Amlodipine Besylate Tablets, USP
Read this information carefully before you start taking amlodipine besylate tablets and each time you refill your prescription. There may be new information. This information does not replace talking with your doctor. If you have any questions about amlodipine besylate tablets, ask your doctor. Your doctor will know if amlodipine besylate tablets are right for you.
What are amlodipine besylate tablets?
Amlodipine besylate tablets are a type of medicine known as a calcium channel blocker (CCB). It is used to treat high blood pressure (hypertension) and a type of chest pain called angina. It can be used by itself or with other medicines to treat these conditions.
High Blood Pressure (hypertension)
High blood pressure comes from blood pushing too hard against your blood vessels. Amlodipine besylate tablets relaxes your blood vessels, which lets your blood flow more easily and helps lower your blood pressure. Drugs that lower blood pressure lower your risk of having a stroke or heart attack.
Angina is a pain or discomfort that keeps coming back when part of your heart does not get enough blood. Angina feels like a pressing or squeezing pain, usually in your chest under the breastbone. Sometimes you can feel it in your shoulders, arms, neck, jaws, or back. Amlodipine besylate tablets can relieve this pain.
Who should not use amlodipine besylate tablets?
Do not use amlodipine besylate tablets if you are allergic to amlodipine (the active ingredient in amlodipine besylate tablets), or to the inactive ingredients. Your doctor or pharmacist can give you a list of these ingredients.
What should I tell my doctor before taking amlodipine besylate tablets?
Tell your doctor about any prescription and non-prescription medicines you are taking, including natural or herbal remedies. Tell your doctor if you:
ever had heart disease
ever had liver problems
are pregnant, or plan to become pregnant. Your doctor will decide if amlodipine besylate tablets is the best treatment for you.
are breast-feeding. Amlodipine passes into your milk.
How should I take amlodipine besylate tablets?
Take amlodipine besylate tablets once a day, with or without food.
It may be easier to take your dose if you do it at the same time every day, such as with breakfast or dinner, or at bedtime. Do not take more than one dose of amlodipine besylate tablets at a time.
If you miss a dose, take it as soon as you remember. Do not take amlodipine besylate tablets if it has been more than 12 hours since you missed your last dose. Wait and take the next dose at your regular time.
Other medicines: You can use nitroglycerin and amlodipine besylate tablets together. If you take nitroglycerin for angina, don't stop taking it while you are taking amlodipine besylate tablets.
While you are taking amlodipine besylate tablets , do not stop taking your other prescription medicines, including any other blood pressure medicines, without talking to your doctor.
If you took too much amlodipine besylate tablets , call your doctor or Poison Control Center, or go to the nearest hospital emergency room right away.
What should I avoid while taking amlodipine besylate tablets?
Do not start any new prescription or non-prescription medicines or supplements, unless you check with your doctor first.
What are the possible side effects of amlodipine besylate tablets?
Amlodipine besylate tablets may cause the following side effects. Most side effects are mild or moderate:
swelling of your legs or ankles
tiredness, extreme sleepiness
stomach pain, nausea
flushing (hot or warm feeling in your face)
arrhythmia (irregular heartbeat)
heart palpitations (very fast heartbeat)
muscle rigidity, tremor and/or abnormal muscle movement
It is rare, but when you first start taking amlodipine besylate tablets or increase your dose, you may have a heart attack or your angina may get worse. If that happens, call your doctor right away or go directly to a hospital emergency room.
Tell your doctor if you are concerned about any side effects you experience. These are not all the possible side effects of amlodipine besylate tablets. For a complete list, ask your doctor or pharmacist.
How do I store amlodipine besylate tablets?
Keep amlodipine besylate tablets away from children. Store at 20º to 25°C (68° to 77º F); excursions permitted between 15° to 30°C (59° to 86°F). Keep amlodipine besylate tablets out of the light. Do not store in the bathroom. Keep amlodipine besylate tablets in a dry place.
General advice about amlodipine besylate tablets
Sometimes, doctors will prescribe a medicine for a condition that is not written in the patient information leaflets. Only use amlodipine besylate tablets the way your doctor told you to. Do not give amlodipine besylate tablets to other people, even if they have the same symptoms you have. It may harm them.
You can ask your pharmacist or doctor for information about amlodipine besylate tablets, or you can contact Unichem Pharmaceuticals (USA), Inc., at 1 866-562-4616
Additional Summary of Information About leaflets can be obtained by calling Unichem at 1-866-562-4616.
Manufactured by:
Pilerne Ind. Estate, Pilerne, Bardez,
Goa 403 511, India.
Ind Area, Meerut Road, Ghaziabad – 201 003, India
Manufactured for:
[Company Logo]
Hasbrouck Heights, NJ 07604
amlodipine besylate tablet
Product Information Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:61919-782(NDC:29300-243) Route of Administration ORAL Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength AMLODIPINE BESYLATE (UNII: 864V2Q084H) (AMLODIPINE - UNII:1J444QC288) AMLODIPINE 10 mg Inactive Ingredients Ingredient Name Strength ANHYDROUS DIBASIC CALCIUM PHOSPHATE (UNII: L11K75P92J) SODIUM STARCH GLYCOLATE TYPE A POTATO (UNII: 5856J3G2A2) CELLULOSE, MICROCRYSTALLINE (UNII: OP1R32D61U) MAGNESIUM STEARATE (UNII: 70097M6I30) Product Characteristics Color white ((white to off-white)) Score no score Shape ROUND Size 11mm Flavor Imprint Code U;243 Contains Packaging # Item Code Package Description Marketing Start Date Marketing End Date 1 NDC:61919-782-30 30 in 1 BOTTLE; Type 0: Not a Combination Product 07/29/2019 Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANDA ANDA203245 07/29/2019 Labeler - Direct_Rx (079254320) Registrant - Direct_Rx (079254320) Establishment Name Address ID/FEI Business Operations Direct_Rx 079254320 repack(61919-782)


text:
15258 Valley Vista Boulevard Sherman Oaks, CA 91403-
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Based on information from CARETS as of 11/12/2023 07:00:00 AM. The information being provided by CARETS is for the visitor's personal, noncommercial use and may not be used for any purpose other than to identify prospective properties visitor may be interested in purchasing. The data contained herein is copyrighted by CARETS, CLAW, CRISNet MLS, i-Tech MLS, PSRMLS and/or VCRDS and is protected by all applicable copyright laws. Any dissemination of this information is in violation of copyright laws and is strictly prohibited. Any property information referenced on this website comes from the Internet Data Exchange (IDX) program of CRISNet MLS and/or CARETS. All data, including all measurements and calculations of area, is obtained from various sources and has not been, and will not be, verified by broker or MLS. All information should be independently reviewed and verified for accuracy. Properties may or may not be listed by the office/agent presenting the information.
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State holidays and Forex
InstaForex Company invites you to look through the information regarding the influence of holidays on financial flows on the leading financial markets and on Forex in particular.
Nearly all financial grounds of the world operate within a 5-working days week. Only Forex can fairly boast of its operations conducted with no breaks. However, on Saturday and Sunday Forex trades are held for only the major currency pairs and the cover is less global than during the working days. Yet, during the holiday calm on Forex the liquidity rate lowers and the intensity of almost all financial flows weakens which leads to significant reduction of the risks related to loss of capital invested in the market.
Such a drop in business activity is caused by the holidays of the major participants of Forex have - commercial and investment banks. Mainly banks ensure financial saturation of Forex flows and other markets. Forex disregards some holidays, however even such a currency giant can be affected by some of them. There is no doubt that Forex and its participants are true workaholics. It is clear that this market is international and it is accumulated in the Internet and also in the accounts of thousands and millions of market makers, brokers and traders. It turns out that as long as the computer with access to internet is switched on, Forex functions. Still, let us return to the state holidays. Not all the state holidays have significance to make a usual day a holiday, and in most countries at that. It can be New Year, Christmas and Labor Day (every country has its own name for this holiday). But the world does not stop for a second, financial flows do not stop as well, informational reasons do not fail too during holidays. It all is very important for traders especially for those who stakes on the fundamental analysis. During the holiday period the market seems to cease functioning, but this is more like calm before the storm. Just remember how often during the holiday one or another micro or macro economical events take place. Politicians announce another resignation or assignment, heads of companies publish their reports and announce about the merger, another crisis took place in a country of the Middle East, president of transnational company refuses in celebrating holidays. All of this is very important and any market which depends on such news will to it as soon as it opens. And Forex will be the first to do it.
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Relationship Mug (Love You mom)
Review: 5 - "A masterpiece of literature" by John Doe, written on May 4, 20020
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Relationship Mugs M0161 20 Oz (4.5")
Relationship Mugs M0161 20 Oz (4.5")
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- The rights to return the goods to us as referred to in clause 4 will not apply in the following circumstances: In the event that the product has been used to any products that we have made or customised specifically for you. The provisions of this clause 4 do not affect your statutory rights.
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Empagliflozin is used for the management and prevention of type II diabetes mellitus. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, lowers the kidneys threshold for glucose and increases urinary glucose excretion by interfering with the reabsorption of kidney-filtered glucose across the tubular lumen of the proximal renal tubules. Empagliflozin decreases fasting and post-prandial blood glucose levels, and imparts a low risk of hypoglycemia as its mechanism of action is independent of beta cell function and insulin pathway.
Affygility Solutions has an occupational exposure limit (OEL) and control band assignment for this active pharmaceutical ingredient (API). This monograph also contains the acceptable daily exposure (ADE) value.
OEL Fastrac monographs are a cost-effective and convenient way to meet the requirements for PDEs (ADEs) contained in the EMA Guideline on setting health based exposure limits for use in risk identification in the manufacture of different medicinal products in shared facilities (EMA/CHMP/CVMP/SWP/169430/2012), as well as PIC/S and ANVISA requirements, and to obtain the following information:
To order an OEL/ADE monograph for Empagliflozin, just click the ADD TO CART button.
If you're wondering about HBEL, we have something for you.
Not the compound you were looking for? You can search the OEL Fastrac catalog to find more available compounds.
Affygility Solutions' OEL Fastrac service is an user-friendly system that enables us to make confident decisions and focus on moving the compound safely through our facility. We can quickly access the database to determine if a new drug is within the OEL Fastrac library, and if so, immediately download a detailed OEL banding report. The OEL Fastrac system has been a helpful tool in our overall EH&S program.


text:
Haikou Meilan International Airport (HAK) is a bigger airport in China. You can fly to 107 destinations with 40 airlines in scheduled passenger traffic.
By using our smart filters you can find flights and destinations matching your requirements.
The prices shown are avarage prices we have estimated for each destination. Click on 'CHECK PRICES' to see an exact price.
Haikou Meilan International Airport (HAK) is a bigger airport in China. You can fly to 107 destinations with 40 airlines in scheduled passenger traffic.
Flights are departing from one of its 3 terminals (Terminal 1, 2 and I). The route with the most departures is the route to Guangzhou (CAN) with an average of 136 flights from Haikou Meilan International Airport every week which is 7% of all weekly departures. The top international destinations from here are Hong Kong (HKG) and Singapore (SIN). The two longest flights are Haikou (HAK) to Melbourne (MEL) that takes around 9 hours and 30 minutes and Haikou (HAK) to Sydney (SYD) with a flight time of 9 hours and 20 minutes.
Hainan Airlines is the largest airline here by counting the number of departures with around 592 scheduled take-offs every week. The second largest operator from Haikou Meilan International Airport is China Southern. Larger aircrafts on this airport are Boeing 777, Airbus A330 and the Boeing 787 Dreamliner. The aircraft types with most scheduled flights are the Airbus A31X/32X and the Boeing 737.
The route with the longest flighttime from Haikou (HAK) is to Melbourne (MEL) and takes about 9h 30min with a Airbus A330-200
Based on number of scheduled departures next month.
Based on number of scheduled departures next month
The most common aircrafts in our database
FlightsFrom.com is a useful website for finding airline routes and flight schedules globally. The idea is being able to explore destination opportunities through non-stop flights from a specific airport. It's a tool to set up your business meeting or weekend holiday based on your timeschedule and your closest airport.
Part of its appeal is that it just makes trips easier to plan; you see the departure times of every non-stop flight in a list.
I always wondered where you could fly direct from a particular airport (Burbank, I'm looking at you) and those answers can be tough to find. Not anymore!
Many mainstream sites don't list low-cost carriers or link transoceanic flights to regionally based carriers that can provide less expensive options. For that, you need a bigger tool kit… (Hint: search by destination airport at FlightsFrom.com)
Many low-cost carriers airlines prevent their flights from showing up on some of these (read Vayama or Google Flights) third-party travel websites. If you want a chance to view all local departures, try using FlightsFrom.com