Ubrelvy and Amlodipine Interaction
Direct Answer
There is no clinically significant drug-drug interaction between Ubrelvy (ubrogepant) and amlodipine, and these medications can be safely co-administered in patients with cardiovascular disease and hypertension. 1
Safety Profile
Amlodipine is a dihydropyridine calcium channel blocker that is safely combined with multiple drug classes and has a lower potential for clinically significant drug interactions compared to non-dihydropyridine calcium channel blockers like diltiazem or verapamil. 2
Key Safety Points:
Amlodipine does not interact with most medications through significant pharmacokinetic mechanisms, as it is primarily metabolized by CYP3A4 but does not significantly inhibit or induce this enzyme. 2
Ubrogepant (Ubrelvy) does not appear in any cardiovascular guideline interactions with calcium channel blockers, indicating no recognized clinical concern. 1, 2
Clinical Management in Cardiovascular Disease
Amlodipine's Role in High-Risk Patients:
Amlodipine is specifically safe and appropriate for patients with cardiovascular disease, including those with:
Heart failure with reduced ejection fraction (HFrEF): Amlodipine appeared safe in patients with severe systolic heart failure in the PRAISE trial, unlike non-dihydropyridine calcium channel blockers (diltiazem, verapamil) which should be avoided. 3
Coronary artery disease: Amlodipine combined with ACE inhibitors showed superior cardiovascular outcomes compared to diuretic combinations in high-risk hypertensive patients. 4
Post-myocardial infarction: Amlodipine and felodipine are well tolerated in patients with mild LV dysfunction, though evidence in acute UA/NSTEMI settings remains limited. 3
Blood Pressure Targets:
Target BP in heart failure patients: <130/80 mmHg, with consideration for lowering to <120/80 mmHg in selected patients. 3
Avoid excessive diastolic BP reduction below 60 mmHg in patients with diabetes, age >60 years, or coronary artery disease with evidence of myocardial ischemia. 3
Monitoring Recommendations
Standard Monitoring:
Blood pressure monitoring should continue as usual when combining these medications, as acute illness (migraine) may affect blood pressure through volume depletion or systemic effects. 1
No additional laboratory monitoring is required specifically for this drug combination. 1, 2
Important Distinctions:
Do not confuse amlodipine with diltiazem or verapamil, which have significant CYP3A4 inhibition and require dose limitations with many medications. 5 This distinction is critical as non-dihydropyridine calcium channel blockers have negative inotropic properties and should be avoided in patients with heart failure or LV dysfunction. 3
Common Pitfalls to Avoid
Do not discontinue amlodipine when prescribing Ubrelvy for migraine treatment, as there is no interaction requiring medication adjustment. 1, 2
Do not assume all calcium channel blockers are equivalent: Amlodipine's safety profile in cardiovascular disease is superior to verapamil and diltiazem, particularly in patients with heart failure. 3
Monitor for additive vasodilatory effects (peripheral edema, flushing, headache) which are typical of amlodipine therapy and not interaction-related. 6