What type of medication is AmLODIPine (Amlodipine) 2.5mg?

Amlodipine 2.5 mg: A Calcium Channel Blocker for Hypertension and Angina

Amlodipine 2.5 mg is a dihydropyridine calcium channel blocker (CCB) primarily used to treat hypertension and angina pectoris by relaxing blood vessels to improve blood flow and reduce blood pressure. 1

Medication Classification and Mechanism

Amlodipine belongs to the dihydropyridine class of calcium channel blockers. It works by:

• Blocking calcium channels in vascular smooth muscle cells
• Preventing calcium entry into cells, leading to vasodilation
• Reducing peripheral vascular resistance
• Lowering blood pressure without significantly affecting heart rate 2

Dihydropyridine CCBs like amlodipine have more specific selectivity for vascular smooth muscle cells peripherally than cardiac cells, making them particularly effective for hypertension and chronic stable angina. 3

Dosage Information

• Starting dose is typically 2.5 mg once daily
• Can be titrated up to 5 mg and then 10 mg if needed
• 2.5 mg is considered the minimum effective dose 4
• Once-daily dosing is sufficient due to its long elimination half-life (40-60 hours) 2
• Can be taken with or without food 1

Clinical Applications

Amlodipine is FDA-approved for:

1. Hypertension (high blood pressure)

   • Can be used as monotherapy or in combination with other antihypertensive agents
   • Produces smooth, dose-dependent blood pressure reductions 5

2. Angina Pectoris

   • Relieves chest pain by improving blood flow to the heart muscle
   • Effective for chronic stable angina 1

Efficacy and Evidence

Amlodipine has been extensively studied in large clinical trials:

• In the ALLHAT study, amlodipine was compared to chlorthalidone (a diuretic) and lisinopril (an ACE inhibitor) for treating hypertension
• The primary outcome of fatal coronary heart disease and nonfatal myocardial infarction did not differ significantly between treatment groups 3
• Amlodipine was effective in reducing blood pressure across various patient subgroups including elderly, young, men, women, black, non-black, and diabetic patients 3

Common Side Effects

The most common side effects of amlodipine include:

• Peripheral edema (swelling of legs/ankles) - dose-related, more common at 10 mg dose
• Dizziness
• Flushing
• Fatigue
• Palpitations 1

Side effects are generally mild to moderate in intensity. Women tend to experience certain side effects (edema, flushing, palpitations) more frequently than men. 1

Special Considerations

• Hepatic impairment: May lead to higher plasma concentrations and longer half-lives
• Renal impairment: Severe impairment may influence pharmacokinetics
• Elderly patients: May have altered pharmacokinetics
• Drug interactions: Minimal compared to other antihypertensives, but caution with certain statins (lovastatin, simvastatin) 3, 6

Advantages of Amlodipine

• Long half-life allowing once-daily dosing
• High bioavailability (60-80%)
• Gradual onset of action, minimizing reflex tachycardia
• Minimal fluctuation in plasma concentration between doses (20-25%)
• No significant effect on heart rate at therapeutic doses 2
• Strong evidence for cardiovascular event reduction 7

Amlodipine is considered a first-line agent for hypertension due to its efficacy, safety profile, and strong evidence from large randomized controlled trials for cardiovascular event reduction. 7