Caduet

About this medication
Taking this medication
Safety Information

Why have I been prescribed CADUET?

Your doctor has prescribed CADUET for you to control your hypertension (high blood pressure) and/or to prevent angina attacks (chest pains), and to help lower your cholesterol or other fats in the blood (such as triglycerides). CADUET is indicated in patients for whom treatment with both amlodipine and atorvastatin is appropriate, specifically, patients at cardiovascular risk.¹

For complete information, please refer to your CADUET consumer information leaflet (found inside your CADUET box).

CADUET is just part of the treatment your doctor will plan with you to help keep you healthy. Depending on the condition of your health and your lifestyle, your doctor may recommend:¹

A change in your diet to control your weight, reduce your cholesterol, reduce intake of saturated fats and increase fibre
Exercise that is right for you
Quitting smoking and avoiding smoky places
Giving up alcohol or drinking less

What is CADUET?

CADUET is a product that contains two active ingredients: amlodipine besylate and atorvastatin calcium.¹

The amlodipine portion of CADUET belongs to a class of medications called “calcium channel blockers”. Calcium channel blockers, like amlodipine, block the transfer of calcium into the cells of the heart and blood vessels. This helps the blood vessels to relax, thereby lowering blood pressure and resulting in less work for the heart.¹

The atorvastatin portion of CADUET belongs to the class of medicines known as “statins”, more specifically called “3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors”. HMG-CoA reductase is an enzyme involved in regulating cholesterol levels in your body. Statins are used along with changes to exercise and diet to help control the amount of cholesterol produced by the body. High levels of cholesterol and other fats can cause heart disease by clogging the blood vessels that feed blood and oxygen to the heart.¹

Atorvastatin can help your body:¹

Decrease low-density lipoprotein (LDL, bad) cholesterol, triglyceride levels and other lipids/fats in the blood
Increase high-density lipoproteins (HDL, good) cholesterol
Decrease the Total Cholesterol HDL-Cholesterol Ratio (TC: HDL-C Ratio). The ratio represents the balance between bad and good cholesterol

What is blood pressure?

Blood pressure is a measure of the pressure or force of blood pushing against the walls of your blood vessels (known as “arteries”).²

When your blood pressure is measured, you get 2 numbers:

The top number represents the pressure when your heart contracts and pushes blood out (systolic)
The bottom number represents the lowest pressure when the heart relaxes between beats (diastolic)

Blood pressure levels are measured in mmHg (millimetres of mercury).

Why is high blood pressure important?

One in four Canadians has high blood pressure. It is a major risk factor for heart disease, so it is very important that it is properly controlled.³
For most people, normal blood pressure is 140/90 mmHg or lower. If you check your blood pressure at home, it should be 135/85 mmHg or lower because you’re usually more relaxed at home. If you have diabetes, it should be less than 130/80 mmHg.⁴

What could happen if I didn’t keep my high blood pressure under control?

You may not feel any symptoms of high blood pressure, but if your blood pressure is left untreated, it can cause damage to your heart and blood vessels, which can lead to a stroke, kidney failure, etc.⁵

What is angina?

Angina (sometimes called “angina pectoris”) occurs when your heart doesn't get as much oxygen as it needs because of a blockage of one or more of the arteries supplying blood to the heart muscle. This blockage causes pain in the chest. People who have angina describe the pain as a squeezing, suffocating or burning feeling.⁶

Why is angina important?

Angina (chest pain) is a warning signal that you suffer from a lack of oxygen of the heart muscle, which might lead to an increased risk of a heart attack. Usually, the pain will go away with rest or medication, but it is your heart telling you that your body is working too hard and needs to slow down. Angina is a warning to you to stop what you are doing and rest.⁶

What is cholesterol?

Cholesterol is a complex, fatty substance (a "lipid") that your body uses to produce many hormones and parts of your cells. Most of the cholesterol in your body is made by your liver. In order to be used properly by your body, cholesterol particles need to move through the bloodstream. To do this, they attach themselves to lipid-carrying proteins ("lipoproteins").
Two types of lipoproteins are important: low-density lipoproteins (LDLs) and high-density lipoproteins (HDLs). Cholesterol carried by LDLs ("LDL-cholesterol") is called "bad" cholesterol, while cholesterol carried by HDLs ("HDL-cholesterol") is called "good" cholesterol.⁷

What is high cholesterol?

If your doctor tells you that you have high LDL-cholesterol, what he or she is really saying is that you have more cholesterol in your blood than your body needs. The higher your LDL-cholesterol level, the greater your risk of developing heart disease.⁷

What could happen if I didn’t keep my high cholesterol under control?

High levels of cholesterol in the blood are one of the factors that increase your risk of cardiovascular disease – disease of the heart or the blood vessels. This means that high cholesterol increases your chance of having a heart attack.⁷

How does CADUET reduce the risk of these conditions?

By lowering blood pressure, CADUET results in less work for the heart. Lowering blood pressure is important, specifically for patients at cardiovascular risk.¹

The atorvastatin portion of CADUET belongs to the class of medicines known as “statins”. Statins are used along with changes to exercise and diet to help control the amount of cholesterol produced by the body. High levels of cholesterol and other fats can cause heart disease by clogging the blood vessels that feed blood and oxygen to the heart.¹

Learn More: Taking this medication >

How much CADUET should I take and how often?

The usual initial antihypertensive oral dosage of amlodipine is 5 mg once daily, and the maximum dose is 10 mg once daily. The recommended starting dosage of atorvastatin is 10 mg to 20 mg once daily. The dosage range is 10 mg to 80 mg once daily. Your doctor will decide on the best dose for you. Your individual health and tolerance to medications will help your doctor decide how much of each ingredient will be best for you.¹

Follow your doctor’s dosing instructions carefully. Take your CADUET as a single dose once a day. Never change the dose unless your doctor tells you to. It does not matter if you take CADUET with food or without food. Ideally, so you won’t forget, you should get in the habit of taking your medicine at the same time every day. Follow the plan that you and your doctor make for diet, exercise, weight control and smoking cessation.¹ Continue to take your medicine even if you do not feel better. It may take a number of weeks for your medicine to start working.

What if I accidentally take too much CADUET?

If you think you have taken too much of CADUET, contact your doctor, nurse, pharmacist, hospital emergency department or regional Poison centre immediately, even if there are no symptoms.¹

What if I forget to take a dose of CADUET?

If you miss taking your medicine, take it as soon you can. But if it is almost time for your next dose, skip the missed dose and just take the next dose. Don't take a double dose.¹

How do I check my blood pressure at home?

To check your blood pressure at home:²

Sit down in a quiet, comfortable place with no distractions or talking, so that you are calm and your blood pressure is not artificially raised
Put your arm on a table, and put the blood pressure cuff at the same height as your heart
Make sure you’re seated in a position with back support
Keep your feet flat on the floor, and don’t cross your legs
Take two measurements in the morning and two in the evening on the same arm and record the readings in a log.

Your blood pressure should be less than 135/85 mmHg if measured at your doctor’s office with an automated device, or when you measure at home (or less than 140/90 mmHg when measured manually by your doctor). If you have diabetes, it should be less than 130/80 mmHg.

If you are planning to buy a home blood pressure monitor, before going to the pharmacy, measure the distance (the circumference) around the middle of your upper arm to make sure that you buy the correct size. Ask your pharmacist to help you choose the right size blood pressure cuff based on this measurement. Blood pressure monitors can be purchased in most pharmacies.²

How should I store CADUET?

Keep your medicine at 15-30^oC (room temperature). Keep out of reach and sight of children.¹

Learn More: Safety information >

Important safety information about CADUET¹

Is it okay to take other medicines while I am taking CADUET?

Tell your doctor, nurse, or pharmacist about all the medicines you take, including drugs prescribed by other doctors, vitamins, minerals, natural supplements, or alternative medicines. Also mention if you drink alcoholic beverages.

Serious Drug Interactions: CADUET can interact significantly with certain medications, such as hepatitis C antivirals, cyclosporine, HIV protease inhibitors, strong inhibitors of CYP 3A4, and clarithromycin.

Does CADUET cause any side effects?

CADUET can cause serious side effects, including:

Worsened angina (chest pain) and heart attacks.
Hypotension (low blood pressure). Your blood pressure should be carefully monitored.
Hypersensitivity (allergic reaction). This has been seen with other statins. If you have allergic reactions, your healthcare professional may stop your treatment.
Hyperglycemia (high blood sugar). Slightly increased blood sugar can occur when you take CADUET. Discuss with your healthcare professional your risk of developing diabetes.
Jaundice. If during treatment you develop jaundice, tell your doctor right away. Your treatment with CADUET may need to be stopped.
Myalgia (muscle pain) and Rhabdomyolysis (muscle tenderness or weakness). Tell your doctor right away if you have muscle pain, tenderness or weakness, especially if you are also feeling unwell or have a fever. Your healthcare professional will perform tests and your treatment with CADUET may need to be stopped.

What side effects of CADUET should I be aware of?

Check with your doctor or pharmacist promptly if any of the following persist or become troublesome:

Stomach pain or upset, vomiting or throwing up, loss of appetite and inability to eat, or malaise (general feeling of being unwell), burping
Gas, constipation, diarrhea
Headache, neck pain
Fever
Hair loss
Skin rash, hives, itchiness
Insomnia (difficulty sleeping), drowsiness, fatigue, nightmares
Impotence (inability to develop or maintain an erection of the penis)
Blurred vision, ringing in the ears
Breathing problems, including persistent cough and/or shortness of breath or fever
Mood-related disorders, including depression
Poor memory, confusion and memory loss

CADUET can also cause abnormal blood test results. Your doctor will decide when to perform blood tests and will interpret the results.

This is not a complete list of side effects. If you notice anything unusual or any unexpected effects while taking CADUET, contact your doctor or pharmacist.

You can report any suspected side effects associated with the use of health products to Health Canada by:

Visiting the Web page on Adverse Reaction Reporting (https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/adverse-reaction-reporting.html) for information on how to report online, by mail or by fax; or
Calling toll-free at 1-866-234-2345.

How will I know if I am having an allergic reaction to CADUET?

Symptoms of an allergic reaction may include:

Skin rash and itching
Fever
Constriction of the airways and wheezing
Swelling of tissues (such as the voice box and the opening between the vocal cords that closes to stop the flow of air to the lungs), which impairs breathing
A drop in blood pressure

If you think you might be having an allergic reaction to CADUET, contact local health services right away.

What else should I tell my doctor before taking CADUET?

Before you use CADUET, talk to your doctor or pharmacist if you:

Have had a stroke or a mini-stroke called a “transient ischemic attack” (TIA)
Regularly drink three or more alcoholic drinks daily
Have kidney or liver problems
Are 65 years of age or older
Are taking fusidic acid
Are taking medicines containing digoxin, ketoconazole, clarithromycin, or ritonavir
Have a narrowed heart valve (aortic stenosis)

Are at a risk for developing myopathy (muscle aching or weakness). Risk factors include if you:

Have ever had muscle problems or have a family history of muscle problems
Have ever had muscle problems during treatment with statins, such as atorvastatin (LIPITOR^®), fluvastatin, lovastatin, pravastatin, rosuvastatin (CRESTOR^®), or simvastatin (ZOCOR^®)
Are taking other medicines to lower cholesterol, such as fibrates (gemfibrozil, fenofibrate) or niacin
Have thyroid problems
Drink large amounts of alcohol
Do excessive physical exercise
Are 65 years of age or older
Have kidney or liver problems
Have diabetes with hepatic fatty change
Recently had surgery or suffered a trauma

Do not take CADUET if:

You are allergic to either amlodipine besylate and/or atorvastatin calcium or other medications known as “dihydropyridines” (for example, felodipine, and nifedipine) or any of the non-medicinal ingredients
You have been diagnosed with low blood pressure (less than 90 mmHg systolic)
You have active liver disease or unexplained increases in liver enzymes
You are pregnant or breast-feeding
You are taking MAVIRET^™ (glecaprevir/pibrentasvir elbasvir/grazoprevir, velpatasvir/sofosbuvir, or ledipasvir/sofosbuvir)
You are taking cyclosporine (e.g., SANDIMMUNE^®, NEORAL^®)

Slightly increased blood sugar can occur when you take CADUET. Discuss with the doctor your risk of developing diabetes.

CADUET may cause muscle pain, aching or weakness that does not go away even after stopping the drug.

Pregnancy:

Before using this medication, discuss the following with your doctor:
- This medicine may be present in your breast milk, so if you are breast-feeding your baby, you should not take CADUET.
- Cholesterol compounds are essential elements for the development of a fetus. Cholesterol-lowering drugs can harm the fetus. If you are of child-bearing age, discuss with your doctor the potential hazards to the fetus and the importance of birth control methods.
- This medicine should not be used by pregnant women. If you become pregnant, discontinue use immediately and discuss with your doctor.

References:

Caduet Product Monograph, https://health-products.canada.ca/dpd-bdpp/
Heart and Stroke Foundation of Canada, 2024. Available at www.heartandstroke.ca/heart-disease/risk-and-prevention/condition-risk-factors/high-blood-pressure Accessed on: December 02, 2024.
Heart and Stroke Foundation of Canada, 2024. Available at www.heartandstroke.ca/what-we-do/media-centre/news-releases/health-professionals-concerned-about-blood-pressure-in-Canada Accessed on: December 02, 2024.
Public Health Agency of Canada. Signs and symptoms of high blood pressure. Government of Canada. www.canada.ca/en/public-health/services/diseases/heart-health/high-blood-pressure/signs-symptoms-high-blood-pressure.html Accessed on: December 02, 2024.
Public Health Agency of Canada. Health effects of high blood pressure. Canada.ca. Available at www.canada.ca/en/public-health/services/diseases/heart-health/high-blood-pressure/health-effects-high-blood-pressure.html Accessed on: December 02, 2024.
Heart and Stroke Foundation of Canada, 2024. Available at www.heartandstroke.ca/heart-disease/conditions/angina Accessed on: December 02, 2024.
Heart and Stroke. Living with Cholesterol. Available at www.wcfht.ca/uploads/1/2/3/0/123093388/living_with_cholesterol.pdf Accessed on: December 02, 2024.