Amlodipine | Side Effects, Dosage, Uses & More
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Amlodipine

Highlights

  1. Amlodipine is an oral drug that’s used to treat high blood pressure, coronary artery disease, and angina.
  2. This drug comes in the form of a tablet you take by mouth.
  3. Amlodipine is available as the brand-name drug Norvasc. It’s also available as a generic drug.

IMPORTANT INFORMATION

Liver problems
Amlodipine is processed by your liver. If you liver isn’t working well, more of this drug may stay in your body longer. This puts you at risk for more side effects. If you have severe liver problems, your doctor may give you a lower dose.

Heart problems
If you have heart problems, such as narrowing of your arteries, this drug may increase your risk of health problems. You may have low blood pressure, worse chest pain, or a heart attack after starting or increasing your dose of amlodipine. If this happens, call your doctor or go to the emergency room right away.

Breastfeeding risk
It isn’t known if amlodipine passes into breast milk. If it does, it may cause serious side effects in a child who is breastfed. You and your doctor may need to decide if you’ll breastfeed or take this medication.


Drug features

Amlodipine is a prescription drug. It comes as a tablet you take by mouth.

Amlodipine is available as the brand-name drug Norvasc. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Amlodipine may be taken in combination with other heart medications.

Why it's used

Amlodipine is used to lower your blood pressure. It can be used alone or in combination with other heart medications.

Amlodipine is also used to help blood flow more easily to your heart when the arteries in your heart are blocked.

How it works

Amlodipine belongs to a class of drugs called calcium channel blockers. A class of drugs refers to medications that work similarly. They are often used to treat similar conditions.

Amlodipine blocks calcium from entering certain tissues and arteries. This makes it easier for them to relax so that blood can flow more easily to your heart. This helps lower your blood pressure. It also reduces your risk for heart attack or stroke. If you’re taking amlodipine for chest pain, this reduces your risk of hospitalization and surgeries due to chest pain.

Amlodipine side effects

More common side effects

The most common side effects that occur with amlodipine include:

  • swelling of your legs or ankles
  • tiredness or extreme sleepiness
  • stomach pain
  • nausea
  • dizziness
  • hot or warm feeling in your face (flushing)
  • irregular heart rate (arrhythmia)
  • very fast heart rate (palpitations)
  • abnormal muscle movements
  • tremors

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • low blood pressure. Symptoms include:
    • severe dizziness
    • lightheadedness
    • fainting
  • more chest pain or a heart attack. When you first start taking amlodipine or increase your dose, your chest pain may get worse or you may have a heart attack. Symptoms include:
    • chest pain or discomfort
    • upper body discomfort
    • shortness of breath
    • breaking out in a cold sweat
    • unusual tiredness
    • nausea
    • lightheadedness
Pharmacist's Advice
Amlodipine may cause extreme sleepiness.

Amlodipine and weight gain

You Asked, We Answered

  • Can amlodipine cause weight gain?
  • Amlodipine may cause fluid to build up in your body because it can make you urinate less. The buildup of fluid in your body can cause weight gain. Taking anti-inflammatory drugs, like ibuprofen, while you are taking amlodipine could increase fluid buildup.

    - Healthline Pharmacist Review Team

Amlodipine may interact with other medications

Amlodipine can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications that might interact with this drug

Heart medications

These drugs can increase the level of amlodipine in your body. This may cause more side effects.
These drugs include:

  • diltiazem

Antifungal medications

These drugs can increase the level of amlodipine in your body. This may cause more side effects.
These drugs include:

  • ketoconazole
  • itraconazole
  • voriconazole

Antibiotics

These drugs can increase the level of amlodipine in your body. This may cause more side effects.
These drugs include:

  • clarithromycin

Antidepressants

These drugs can increase the level of amlodipine in your body. This may cause more side effects.
These drugs include:

  • nefazodone

Human immunodeficiency virus (HIV) medications

These drugs can increase the level of amlodipine in your body. This may cause more side effects.
These drugs include:

  • ritonavir
  • saquinavir

Seizure medications

These medications can lower the level of amlodipine in your body. This may affect how well the drug works for you.
These drugs include:

  • carbamazepine
  • phenobarbital
  • primidone
  • phenytoin

Tuberculosis medications

These medications can lower the level of amlodipine in your body. This may affect how well the drug works for you.
These drugs include:

  • rifampin

Medications for erection problems

Taking these drugs together may increase your risk of low blood pressure (hypotension).
These drugs include: 

  • sildenafil

Cholesterol medications

Taking these drugs together may cause the levels of the cholesterol medications to increase in your body. This may lead to more side effects.
These drugs include:

  • simvastatin

Drugs that control your immune system

Amlodipine may cause the levels of these medications to increase in your body. This may lead to more side effects.
These drugs include:

  • cyclosporine
  • tacrolimus

AMLODIPINE WARNINGS

People with liver problems
Amlodipine is processed by your liver. If your liver isn’t working well, more of this drug may stay in your body longer. This puts you at risk for more side effects. If you have severe liver problems, your doctor may lower your dose.

People with heart problems
If you have heart problems, such as narrowing of your arteries, this drug may increase your risk of health problems. You may have low blood pressure, worse chest pain, or a heart attack after starting or increasing your dose of amlodipine. If this happens, call your doctor or go to the emergency room right away.

Pregnant women
Amlodipine is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Amlodipine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding
It isn’t known if amlodipine passes into breast milk and causes side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your baby. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors
As you age, your organs (such as your liver, heart, or kidneys) may not work as well as they did compared to when you were younger. More of this drug may stay in your body longer. This puts you at risk for more side effects.

For children
This medicine hasn’t been studied in children and shouldn’t be used in children younger than 6 years.

Allergies
Amlodipine can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Don’t take this drug again if you’ve ever had an allergic reaction to it before. Taking it a second time after an allergic reaction could be fatal.


How to take amlodipine

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

High blood pressure (hypertension)

Brand: Norvasc
Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10mg

Generic: amlodipine
Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10mg

Adult Dosage (ages 18-64 years)

  • starting dose: 5 mg taken by mouth once per day.
  • dose increases: Your doctor may change your dose based on your blood pressure goals. If your blood pressure is still not under control after 7–14 days, your doctor may increase your dose.
  • maximum dose: 10 mg per day.

Child Dosage (ages 0-5 years)
This medicine hasn’t been studied in children and shouldn’t be used in children younger than 6

Child Dosage (ages 6-17 years)
2.5–5 mg taken by mouth once per day. Doses above 5 mg haven't been studied in children and shouldn’t be used.

Senior Dosage (ages 65 years and older)

  • The recommended dose is 2.5 mg taken by mouth once per day.
  • Older adults may process drugs more slowly. A normal adult dose may cause levels of amlodipine to be higher than normal. If you’re a senior, you may need a lower dose.

Special considerations

Liver disease: The recommended dose is 2.5 mg taken by mouth once per day. Amlodipine is processed by your liver. If your liver isn’t working well, more of this drug may stay in your body longer. This puts you at risk for side effects. If you have severe liver problems, you may need a lower dose or a different dosing schedule.

Coronary artery disease and angina

Brand: Norvasc
Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10mg

Generic: amlodipine
Form: Oral tablet
Strengths: 2.5 mg, 5 mg, 10mg

Adult Dosage (ages 18-64 years)

  • starting dose: 5 mg taken by mouth once per day.
  • maximum dose: 10 mg per day.

Senior Dosage (ages 65 years and older)

  • The recommended dose is 5 mg taken by mouth once per day.
  • Older adults may process drugs more slowly. A normal adult dose may cause levels of amlodipine to be higher than normal. If you’re a senior, you may need a lower dose.

Special considerations

Liver disease: The recommended dose is 2.5 mg taken by mouth once per day. Amlodipine is processed by your liver. If your liver isn’t working well, more of this drug may stay in your body longer. This puts you at risk for side effects. If you have severe liver problems, you may need a lower dose or a different dosing schedule.

Pharmacist's Advice
Amlodipine comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all or stop taking it
If you don’t take amlodipine or stop taking it, your blood pressure or chest pain may get worse. This could lead to serious problems, such as a stroke or heart attack.

If you skip or miss doses
If you skip or miss doses, your blood pressure or chest pain may get worse. This could lead to serious problems, such as a stroke or heart attack.

What to do if you miss a dose
If you miss a dose, take it as soon as you remember. If it’s been more than 12 hours since you missed your dose, skip that dose and take the next dose at your regular time.

If you take too much
If you take too much amlodipine, you may experience dangerously low blood pressure. Symptoms include: dizziness, lightheadedness, fainting, very fast heart rate, and shock

There is no antidote for this medication. If you take too much, you’ll be treated for whatever side effects you have.

If you think that you’ve taken too much amlodipine, call your doctor or poison control center, or go to the emergency room right away.

How to tell if the drug is working
If amlodipine is working, your blood pressure will be lower and you’ll no longer have chest pain.

Amlodipine is a long-term drug treatment.

Important considerations for taking this drug

Take amlodipine at the same time every day

You can cut or crush the tablet

This drug must be stored at the right temperature:

  • Store amlodipine at room temperature between 59°F (15°C) and 86°F (30°C).
  • Store this drug in its original container and keep it tightly closed.
  • Keep it away from light.
  • Keep it away from high temperature.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

This medication is refillable

When traveling with your medication:

  • Always carry it with you, such as in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt this medication.
  • •You may need to show airport staff your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • Don’t leave this medicine in the car, especially when the temperature is hot or freezing.

You may need to check your blood pressure at home
You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

Your doctor may ask you to purchase a blood pressure monitor to check your blood pressure between office visits.

Before starting and during your treatment with this drug, your doctor may check your:

  • blood pressure
  • liver function: These blood tests will help your doctor decide if amlodipine is safe for you to start and if you need a lower dose.

Some pharmacies may not stock the brand Norvasc
Most pharmacies should have the generic form of amlodipine in stock, but they may not have the brand Norvasc available. Call ahead if your doctor prescribes Norvasc.

You may need to purchase a home blood pressure monitor to keep track of your blood pressure
These are available at most pharmacies and medical supply stores.

Many insurance companies will require a prior authorization before they approve the prescription for brand name Norvasc

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Amlodipine professional information

Brand name

Norvasc

Indications for use

Amlodipine is 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.

Amlodipine is indicated for the symptomatic treatment of chronic stable angina. It can be used alone or in combination with other antianginal agents.

Amlodipine is indicated for the treatment of vasospastic angina.

Amlodipine is indicated to reduce the risk of hospitalizations due to angina and to reduce the risk of a coronary revascularization procedure in patients with recently documented coronary artery disease by angiography and without heart failure or an ejection fraction of < 40%.

Contraindication

Known allergy to amlodipine.

Warnings/precautions

Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. However, acute hypotension is unlikely.

Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of amlodipine besylate, particularly in patients with severe obstructive coronary artery disease.

Titrate slowly in patients with severe hepatic impairment.

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.

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 besylate 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 besylate 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 besylate in vasospastic (Prinzmetal's or variant) angina.

Dosing in adults

5 mg once a day with maximum dose of 10 mg daily.

Dosing in children

2.5 mg to 5 mg once a day. Doses above 5 mg daily have not been studied in pediatrics.

Dosing in elderly

Small, fragile, or elderly patients may be started on 2.5 mg once per day.

Dosing in renal impairment

NA

Dosing in hepatic impairment

Titrate dose slowly in severe hepatic impairment. Begin with 2.5 mg once per day.

Drug interactions

Do not exceed a simvastatin dose greater than 20 mg a day when combined with amlodipine.

Monitor cyclosporine or tacrolimus levels if given with amlodipine.

Adverse drug reactions

Most common adverse reaction to amlodipine is edema which occurred in a dose-related manner. Other adverse experiences not dose related but reported with an incidence >1.0% are fatigue, nausea, abdominal pain, and somnolence.

Monitoring parameters

NA

Pregnancy risk factor

C- No adequate and well controlled trials in pregnancy. Use only if the benefits outweigh the risks.

Preparation of suspension

NA


Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. The drug information contained herein is for informational purposes only. Data sources include the drug manufacturer’s prescribing information and package insert.

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