Amlodipine besylate is a commonly prescribed medicine used to control high blood pressure (hypertension) and certain types of angina, or chest pain. It belongs to a group of medicines called calcium channel blockers (CCBs).
Amlodipine works mainly by relaxing and widening the blood vessels. This allows blood to flow more easily and reduces the pressure against the walls of the blood vessels. It also reduces the workload on the heart.
Amlodipine is available in different strengths, commonly including 2.5 mg, 5 mg, and 10 mg tablets, depending on the product and country.
It is an effective medicine, but it should be taken regularly according to the instructions of a doctor or pharmacist.
What Is Amlodipine Besylate?
Amlodipine besylate is the besylate salt form of amlodipine. It belongs to the dihydropyridine class of calcium channel blockers.
The medicine is primarily used to:
- Control high blood pressure
- Treat certain types of angina
- Help manage certain patients with coronary artery disease
Amlodipine does not permanently cure high blood pressure. Instead, it helps control blood pressure while you continue taking it.
Brand Names of Amlodipine
Amlodipine may be sold under different brand names depending on the pharmaceutical company and country.
Some commonly known brand names include:
- Norvasc
- Amlokind
- Amlopres
- Amlovas
- Katerzia
- Amlsafe
- Amtas
- Amlodac
- Amlong
- My Amlo
Some products may contain amlodipine together with another blood pressure medicine. Therefore, always check the active ingredients and strength printed on the medicine package.
Brand names can vary between countries and may change over time. The generic medicine contains the same active ingredient as the corresponding brand product, although inactive ingredients and price may differ.
Uses of Amlodipine
Amlodipine is mainly used for cardiovascular conditions. The most common uses are explained below.
1. High Blood Pressure
Amlodipine is widely used to treat hypertension.
High blood pressure means that the pressure of blood against the walls of the arteries remains higher than recommended over time. Many people with hypertension do not notice any symptoms, which is why regular blood pressure measurement is important.
If high blood pressure remains uncontrolled for a long time, it can increase the risk of serious problems such as heart disease, stroke and kidney disease.
Amlodipine lowers blood pressure by relaxing the blood vessels and making it easier for blood to flow.
2. Angina or Chest Pain
Amlodipine can be used to treat certain types of angina, a condition in which reduced blood supply to the heart muscle can cause chest pain or discomfort.
It helps by relaxing blood vessels and improving blood flow to the heart.
However, amlodipine is not a medicine that should be relied upon to immediately stop an episode of chest pain. If new, severe, or unexplained chest pain occurs, seek urgent medical attention.
3. Coronary Artery Disease
Amlodipine may also be used in certain patients with coronary artery disease.
Your doctor may prescribe amlodipine alone or together with other cardiovascular medicines depending on your blood pressure, symptoms, medical history, and treatment goals.
Why Does Blood Pressure Increase?
Blood pressure can increase for many different reasons. Sometimes there is no single identifiable cause.
Factors associated with high blood pressure can include:
- Increasing age
- Family history
- Overweight or obesity
- High-salt diet
- Lack of physical activity
- Smoking
- Excessive alcohol consumption
- Long-term stress
- Kidney disease
- Sleep apnea
- Certain hormonal or medical conditions
- Some medicines
High blood pressure is not simply caused by calcium ions. Several systems in the body work together to regulate blood pressure.
Lifestyle changes can also help control blood pressure. These may include eating a healthier diet, reducing excess salt, maintaining a healthy weight, exercising regularly, avoiding smoking, and limiting alcohol.
Mechanism of Action of Amlodipine
Amlodipine is a calcium channel blocker.
Calcium is important for contraction of smooth muscle cells in blood vessels. Amlodipine blocks the entry of calcium through certain calcium channels in vascular smooth muscle.
As a result, the blood vessels relax and widen.
This causes:
Amlodipine → Calcium channel blockade → Blood vessel relaxation → Wider blood vessels → Reduced blood pressure
The main blood-pressure-lowering effect of amlodipine comes from its action on vascular smooth muscle.
Amlodipine Dosage
The correct dose of amlodipine depends on the patient's age, medical condition, blood pressure response, and other factors.
For many adults with hypertension, the usual starting dose is 5 mg once daily. In some patients, including smaller or older patients or people with liver impairment, a doctor may start with 2.5 mg once daily.
The dose may be increased when necessary, and the usual maximum adult dose is 10 mg once daily.
Amlodipine can be taken:
- Once daily
- With or without food
- At approximately the same time each day
You do not have to take it specifically after breakfast. The important point is to take it consistently at the time recommended by your healthcare professional.
Do not change your dose yourself.
Side Effects of Amlodipine
Amlodipine is generally well tolerated, but side effects can occur.
Common side effects include:
- Swelling of the ankles, feet, or lower legs
- Headache
- Dizziness
- Flushing or a warm feeling
- Tiredness
- Nausea
- Stomach discomfort
- Sleepiness in some people
Ankle or leg swelling, known as peripheral edema, is one of the more characteristic side effects of amlodipine.
Not everyone experiences side effects, and some symptoms may become less troublesome as the body adjusts to the medicine.
When Should You Contact a Doctor?
Seek medical advice if side effects are severe, persistent, or getting worse.
Get urgent medical help if you develop:
- Fainting
- Severe dizziness
- Severe or worsening chest pain
- A very rapid, pounding, or irregular heartbeat
- Signs of a serious allergic reaction
- Difficulty breathing
- Swelling of the face, lips, tongue, or throat
What Happens If Amlodipine Is Overdosed?
Taking too much amlodipine can be dangerous.
An overdose may cause:
- Severe dizziness
- Drowsiness
- Fainting
- Rapid or abnormal heartbeat
- Very low blood pressure
- Weakness
- Shock in severe cases
If you believe you or someone else has taken too much amlodipine, seek emergency medical assessment immediately.
Do not wait for serious symptoms to appear before seeking help.
What Should I Do If I Miss a Dose?
If you forget to take your usual dose, take it when you remember unless it is already close to the time of your next dose.
If the next dose is due soon, skip the missed dose and continue with your normal schedule.
Do not take two doses together to make up for a missed dose.
Can I Drink Alcohol While Taking Amlodipine?
Alcohol can contribute to dizziness or lightheadedness and may make some people feel worse while taking blood pressure medicines.
If you drink alcohol while taking amlodipine, do so cautiously and follow your doctor's advice.
If you notice dizziness or unusual weakness, avoid activities such as driving until you feel normal.
Are There Any Foods I Should Avoid?
Unlike some other calcium channel blockers, grapefruit is not routinely listed as a food that must be avoided with amlodipine.
However, always tell your doctor or pharmacist about your regular diet, supplements, and other medicines if you have concerns about interactions.
Do not make major dietary changes solely because of information about another calcium channel blocker.
How Long Does Amlodipine Take to Work?
Amlodipine begins to work after you take it, but the full blood-pressure-lowering effect may take time to develop.
Doctors may allow several days or more to assess how well the medicine is controlling your blood pressure before deciding whether the dose needs adjustment.
Do not stop taking amlodipine simply because you do not feel a noticeable difference. High blood pressure often has no obvious symptoms, even when it is elevated.
How Long Will I Need to Take Amlodipine?
The duration of treatment depends on your medical condition and blood pressure.
Some people need amlodipine for many years. Others may have their treatment changed if their health or treatment plan changes.
If you stop taking amlodipine without medical advice, your blood pressure may rise again.
Therefore, continue taking it as prescribed and discuss any concerns with your doctor rather than stopping the medicine yourself.
Is Amlodipine Safe During Pregnancy and Breastfeeding?
Pregnancy and breastfeeding require individual medical advice.
Amlodipine should not simply be labelled as “unsafe” or “not recommended” for every pregnant or breastfeeding woman. If you are pregnant, planning pregnancy, or breastfeeding, tell your doctor so the benefits and potential risks can be considered for your particular situation.
Do not stop a blood pressure medicine suddenly without speaking to your healthcare professional.
Who Should Be Careful With Amlodipine?
Tell your doctor before taking amlodipine if you:
- Have had an allergic reaction to amlodipine
- Have liver disease
- Have heart disease
- Have heart failure
- Have very low blood pressure
- Have experienced severe dizziness or fainting
- Are pregnant or planning pregnancy
- Are breastfeeding
- Take other prescription medicines, supplements, or herbal products
People with liver problems may require careful dose selection because amlodipine is extensively metabolized by the liver.
Amlodipine and Other Blood Pressure Medicines
Amlodipine may sometimes be prescribed together with other antihypertensive medicines when one medicine does not provide sufficient blood pressure control.
Examples of other blood pressure medicines include:
- Losartan
- Enalapril
- Atenolol
- Other calcium channel blockers
- Diuretics
The combination should be selected by a healthcare professional based on the patient's condition.
For pharmacy students interested in cardiovascular pharmacology, our Nepal Pharmacy Council Past Questions article also contains questions related to amlodipine and other antihypertensive medicines.
Frequently Asked Questions About Amlodipine
What is amlodipine used for?
Amlodipine is mainly used to treat high blood pressure and certain types of angina. It may also be used in some patients with coronary artery disease.
What is the usual dose of amlodipine?
For many adults with high blood pressure, the usual starting dose is 5 mg once daily. Depending on the patient, a doctor may prescribe 2.5 mg or increase the dose up to 10 mg once daily.
Can amlodipine be taken on an empty stomach?
Yes. Amlodipine can generally be taken with or without food. Try to take it at approximately the same time every day.
Does amlodipine need to be taken in the morning?
No. It can generally be taken at any convenient time of day. The important thing is to take it consistently at approximately the same time each day.
Does amlodipine cause ankle swelling?
Yes. Swelling of the feet, ankles, or lower legs is a common side effect of amlodipine.
Can I stop amlodipine when my blood pressure becomes normal?
Do not stop it without speaking with your doctor. A normal blood pressure reading may mean that the medicine is effectively controlling your blood pressure.
Can I take amlodipine with grapefruit?
Grapefruit is not generally required to be avoided with amlodipine in the way it is with some other medicines. If you take several medicines, ask your pharmacist about possible food or drug interactions.
Is amlodipine safe during pregnancy?
If you are pregnant or planning pregnancy, speak with your doctor. Your doctor will consider your blood pressure, other treatment options, and the potential benefits and risks before deciding what medicine is appropriate.
What should I do if I accidentally take too much amlodipine?
An overdose can cause severe low blood pressure, dizziness, fainting, and other serious effects. Seek emergency medical assessment if you think you have taken too much.
Final Thoughts
Amlodipine besylate is a widely used calcium channel blocker that helps control high blood pressure and certain types of angina.
It works mainly by relaxing and widening blood vessels, which makes it easier for blood to flow and helps lower blood pressure. The usual adult starting dose for hypertension is often 5 mg once daily, although some patients may start with 2.5 mg. The dose may be adjusted according to the individual's response, with 10 mg once daily generally being the maximum adult dose.
Amlodipine is usually taken once daily and can be taken with or without food. Common side effects include ankle swelling, headache, dizziness, flushing, tiredness, and nausea.
Because high blood pressure often causes no symptoms, regular blood pressure monitoring is important even when you feel well.
Do not change the dose or stop amlodipine without medical advice. If you experience severe dizziness, fainting, worsening chest pain, an irregular heartbeat, or signs of a serious allergic reaction, seek medical attention promptly.
References
-
MedlinePlus – Amlodipine Drug Information
https://medlineplus.gov/druginfo/meds/a692044.html -
FDA – Norvasc (Amlodipine Besylate) Prescribing Information
https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/019787s054lbl.pdf -
MedlinePlus – Calcium Channel Blocker Overdose
https://medlineplus.gov/ency/article/002580.htm
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