Warnings for special population
Pregnancy
This medicine is not recommended for use in pregnant women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine. Your doctor may prescribe a safer alternative based on your clinical condition.
Breast-feeding
This medicine is not recommended for use in breastfeeding women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine.
General warnings
Heart Failure
Use of this medicine decreases cardiac function and reduced flow of blood especially in people having a heart disorder causing heart failure. Suitable dose adjustment and safety monitoring might be required based on the severity of the disease.
Ischemic Heart Disease
Use of this medicine should not be discontinued abruptly in patients with Ischemic heart disease. The dosage should be gradually reduced over a period of 1 to 2 weeks.
Major surgery
This medicine should be given with caution to patients who are going to undergo major surgery. The dose should be very carefully monitored in such cases both before and after the surgical procedure.
Pheochromocytoma
This medicine should be administered with extreme caution in patients suffering from pheochromocytoma, a condition which results in an excess of a substance that controls heartbeat and blood pressure. Appropriate corrective measures, dose adjustments, or replacement with a suitable alternative may be necessary based on the clinical condition.
Bronchospastic Disease
This medicine should be administered with caution in patients with a disease of the lung or the airways leading to the lungs such as pneumonia, asthma, or chronic obstructive pulmonary disease. Close monitoring of lung function is recommended for such patients. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Diabetes and Hypoglycemia
This medicine should be administered with caution in patients having elevated blood sugar levels.This medicine may mask certain symptoms of hypoglycemia which may cause serious adverse effects.
Thyrotoxicosis
This medicine should be administered with caution in patients having elevated thyroid hormone levels. Some adverse effects may not be evident in these cases and abrupt stopping of this medicine may cause an abnormal rise in thyroid hormones.
Peripheral Vascular Diseases
This medicine should be used with caution in patients having narrowed blood vessels in the body due to any underlying reason. Dose adjustment and safety monitoring might be required in such cases.
Other Medicines
This combination medicine may interact with many other medicines and may cause severe adverse effects. Hence, it is advised that you inform the doctor about all your current medicines including any herbs and supplements before beginning treatment with this medicine.
Sports
It is advised to not indulge in certain sports while this medicine is consumed. Archery, racing, shooting and other high-risk sports should be avoided. Sports-persons should refer to the list of medicine published by World Anti-Doping Agency which is not to be taken while participating in specific sports events.
Hypotension
This medicine should be used with extreme caution in patients suffering from aortic stenosis due to the increased risk of very low blood pressure. Close monitoring of blood pressure is recommended for such patients. An alternative treatment option should be considered in some cases based on the clinical condition.
Heart attack
This medicine should be used with caution while starting or increasing the dose in patients with coronary artery diseases as it may worsen the symptoms of a heart attack.
Liver Disease
This medicine should be used with extreme caution in patients having an impaired liver function due to the increased risk of adverse effects. Regular monitoring of liver function tests is necessary for such patients. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Drug Withdrawal
Abrupt discontinuation of this medicine may increase the risk of increased chest pain (angina). A gradual dose reduction is recommended to avoid these reactions. Do not stop the use of this medicine without consulting your doctor.
Use in Children
This medicine is not recommended for use in patients below 18 years of age since the safety and efficacy of use are not clinically established.