From the Guidelines
Amlodipine is a calcium channel blocker medication primarily used to treat high blood pressure and certain types of chest pain (angina). The typical starting dose is 5 mg once daily, which may be increased to a maximum of 10 mg daily if needed for blood pressure control. Amlodipine works by relaxing and widening blood vessels, allowing blood to flow more easily and reducing the workload on the heart. This medication should be taken at the same time each day, with or without food, and patients should continue taking it even if feeling well, as hypertension often has no symptoms.
Some key points to consider when using amlodipine include:
- Common side effects include ankle swelling, headache, flushing, and dizziness, which typically improve over time.
- Patients should avoid grapefruit products while taking amlodipine as they can increase the medication's concentration in the bloodstream.
- It's essential to monitor blood pressure regularly while using this medication and inform healthcare providers of all other medications being taken to avoid potential interactions.
- Amlodipine may take 1-2 weeks to show its full effect on blood pressure control.
According to the most recent guidelines, such as the 2022 AHA/ACC/HFSA guideline for the management of heart failure 1, amlodipine may be used for the treatment of hypertension in patients who have elevated blood pressure despite optimization of guideline-directed medical therapy. However, it is crucial to consider the individual patient's condition and medical history before initiating or adjusting any medication.
In terms of specific patient populations, amlodipine can be used in patients with mild left ventricular dysfunction, but its use in patients with severe left ventricular dysfunction or heart failure should be approached with caution, as noted in the 2013 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction 1.
Overall, amlodipine is a valuable medication for managing high blood pressure and certain types of chest pain, but its use should be guided by the most current clinical evidence and individual patient needs.
From the FDA Drug Label
Amlodipine besylate is a type of medicine known as a calcium channel blocker (CCB). It is used to treat high blood pressure (hypertension) and a type of chest pain called angina. Amlodipine besylate relaxes your blood vessels, which lets your blood flow more easily and helps lower your blood pressure. Amlodipine besylate can relieve this pain [angina].
The use of Amlodipine is to treat:
- High Blood Pressure (Hypertension): by relaxing blood vessels and lowering blood pressure
- Angina: by relieving chest pain and improving blood flow to the heart 2 It works as a calcium channel blocker to inhibit the influx of calcium ions into vascular smooth muscle and cardiac muscle, resulting in vasodilation and reduced peripheral vascular resistance 2
From the Research
Uses of Amlodipine
- Amlodipine is a dihydropyridine calcium antagonist used in the treatment of hypertension and stable coronary artery disease (CAD) 3, 4, 5, 6, 7
- It can be used once daily due to its pharmacokinetics, which maintain effective blood levels throughout the dosing interval 3
- Amlodipine has antihypertensive efficacy superior to verapamil and comparable with atenolol, hydrochlorothiazide, captopril, or nitrendipine 3
- It can produce important additional antihypertensive effects when used in combination with angiotensin converting enzyme inhibitors, beta-blockers, or thiazide diuretics 3
Benefits of Amlodipine
- Amlodipine has a low renal clearance and long half-life, allowing it to sustain its anti-hypertensive effect for more than 24 hours following a single dose 5
- It reduces blood pressure variability and successfully lowers blood pressure 5
- Amlodipine controls blood pressure in patients with a systolic/diastolic blood pressure of 130/80 mm Hg or higher, diabetes, or chronic kidney disease without worsening glycemic or kidney function 5
- It is a wise choice for older adults due to its ability to control blood pressure and protect against stroke and myocardial infarction 5
Combination Therapy with Amlodipine
- The fixed combination of perindopril (an ACE inhibitor) and amlodipine may have a positive impact on cardiovascular mortality and morbidity in hypertensive individuals 6
- This combination represents a simplified management strategy for stable CAD, addressing both guideline-recommended management of CAD in a single tablet 6
- Amlodipine can be used as a first-line antihypertensive agent, with good efficacy and safety, and strong evidence from large randomized controlled trials for cardiovascular event reduction 7