AMLODIPINE: Uses, Dosage, Contraindications & Side Effects

Chemical structure: 

Class of medication: Calcium channel blocker

Sub-class: Dihydropyridine

Mode of action:

It reduces peripheral vascular resistance and Blood Pressure by inhibiting the entry of calcium into excitable cells. 

Medicinal forms:

Tablets and ‘on-request’ oral suspensions

Some brands available:

Norvasc, Istin, Amlostin, Amedin

Indications and dose

Hypertension, Prizmental’s Angina and Chronic stable angina

Initially, 5 mg once daily, dose is individualized and may be increased after 1-2 weeks. Maximum is 10mg daily 

May be taken with or without food. 

Contraindications to the use of Amlodipine

·      Cardiogenic shock

·      Significant aortic stenosis

·      Unstable angina 

·      Severe hypotension

Cautions to the use of Amlodipine

·      Peripheral edema

Amlodipine Interactions

·      Increased serum concentration of simvastatin

·      Increased systemic plasma concentration with immunosuppressants

·      Decreased plasma concentration with CYP₄₅₀3A4 inducers.

Side effects/adverse effects

·      Peripheral edema

·      Thrombocytopenia

·      Bradycardia

·      GI disturbances

·      Headache

·      Arthralgia

·      Myalgia

·      Constipation

·      Diarrhea

·      Vision disturbances

·      Elevated hepatic enzymes

·      Pulmonary edema

PREGNANCY: Can Amlodipine be used in Pregnant women?

It is rated as Category C

Manufacturer advises avoid, but risk to fetus should be balanced against risk of uncontrolled maternal hypertension 

BREASTFEEDING: Can lactating mothers take Amlodipine?

Manufacturer advises avoid

HEPATIC IMPAIRMENT: Can I take amlodipine if I have a liver problem

Yes but it is recommended that you initiate at lose dose and titrate slowly.

MONITORING REQUIREMENTS: What should I look out for when taking Amlodipine?

Monitor pulse, heart rate, BP weight and peripheral edema

OTHER MEDICATIONS IN CLASS

·      Nifedipine

·      Felodipine 

·      Verapamil