Amlodipine for Blood Pressure
You are asking about amlodipine, a calcium channel blocker used to treat hypertension. 1
What is Amlodipine?
Amlodipine is a dihydropyridine calcium channel blocker (CCB) that relaxes blood vessels, allowing blood to flow more easily and lowering blood pressure. 1 It is a long-acting medication that provides smooth 24-hour blood pressure control with once-daily dosing. 2, 3
Dosing and Administration
- Starting dose: 5 mg once daily 1, 2
- Maximum dose: 10 mg once daily 1, 4
- Timing: Can be taken with or without food, ideally at the same time each day 1
- Duration of action: The elimination half-life is 35-50 hours, providing blood pressure control that extends beyond 24 hours 5
Clinical Effectiveness
Amlodipine is highly effective for blood pressure reduction, with mean reductions of approximately 23/13 mmHg (supine) and 24/12 mmHg (standing) in clinical trials. 2 Target blood pressure is reached in 73% of patients on 10 mg once daily. 4
The drug maintains consistent blood pressure control throughout the dosing interval without causing orthostatic hypotension or tolerance with long-term use. 2, 3
Combination Therapy
Amlodipine can be effectively combined with:
- ACE inhibitors or ARBs (angiotensin receptor blockers) 3, 6
- Beta-blockers 3, 6
- Thiazide diuretics 3, 7
These combinations produce important additional antihypertensive effects when monotherapy is insufficient. 3
Safety Considerations in Heart Failure
Amlodipine is safe to use in patients with heart failure, unlike non-dihydropyridine calcium channel blockers (diltiazem, verapamil) which should be avoided. 7
- Amlodipine showed neutral effects on mortality in heart failure patients in the PRAISE trials 7
- It may be used for blood pressure control after optimization of guideline-directed medical therapy for heart failure 7
- Non-dihydropyridine CCBs (diltiazem, verapamil) are contraindicated in heart failure due to negative inotropic effects 7
Common Side Effects
- Swelling of legs or ankles (peripheral edema) 1
- Dizziness 1
- Flushing (hot or warm feeling in face) 1
- Fatigue 1
- Stomach pain or nausea 1
These side effects are typically mild to moderate. 1
Important Precautions
- Do not stop taking amlodipine abruptly without consulting your doctor 1
- Inform your doctor about all other medications, including over-the-counter drugs and supplements 1
- Rarely, when first starting or increasing the dose, angina may worsen—seek immediate medical attention if this occurs 1
- Avoid use if allergic to amlodipine or its inactive ingredients 1