Amlodipine

Brand names: Norvasc, Istin, Amlovasc

Dihydropyridine calcium channel blocker

Amlodipine is one of the most widely prescribed blood pressure medications in the world. A calcium channel blocker taken once daily, it effectively lowers blood pressure, treats angina, and has a very long half-life that makes missed doses less problematic.

Drug Class

Dihydropyridine calcium channel blocker

Category

Heart & Blood Pressure

Forms Available

Tablets (2.5 mg, 5 mg, 10 mg)

How It Works

Amlodipine blocks voltage-gated L-type calcium channels in vascular smooth muscle and cardiac muscle. By reducing calcium entry, it relaxes blood vessel walls (vasodilation), lowering peripheral vascular resistance and blood pressure. It has greater vascular than cardiac selectivity, so it has minimal direct effect on heart rate.

What It's Used For

  • Hypertension (high blood pressure)
  • Stable angina
  • Vasospastic (Prinzmetal's) angina
  • As part of combination antihypertensive therapy

Available Forms

Tablets (2.5 mg, 5 mg, 10 mg)

Side Effects

Common Side Effects

  • Peripheral oedema (ankle swelling) — the most common complaint, dose-dependent
  • Flushing and facial warmth
  • Headache
  • Dizziness
  • Palpitations

Serious Side Effects

  • Severe hypotension (usually only with very high doses or severe overdose)
  • Gingival hyperplasia (gum overgrowth) — rare, reversible on stopping
  • Rarely, worsening angina at initiation

Drug Interactions

  • Strong CYP3A4 inhibitors (clarithromycin, azole antifungals) — raise amlodipine levels
  • Simvastatin — amlodipine raises simvastatin levels; limit simvastatin to 20 mg/day if co-prescribed
  • Ciclosporin — increased ciclosporin levels

When to Avoid

  • Cardiogenic shock
  • Severe aortic stenosis (relative)
  • Known allergy to dihydropyridines

Patient Tips

  • Take at the same time each day; food does not significantly affect absorption
  • Ankle swelling is common — elevate your legs when sitting; may resolve over weeks
  • Do not stop suddenly without medical advice — blood pressure can rebound
  • Blood pressure medicines work best alongside a low-salt diet, regular exercise, and healthy weight
  • Measure your blood pressure at home to track the response to treatment

Managing ankle swelling

Ankle oedema with amlodipine results from preferential dilation of pre-capillary arterioles over post-capillary venules, increasing hydrostatic pressure in capillary beds. It is not dangerous and does not indicate fluid overload (unlike cardiac or renal oedema).

Adding an ACE inhibitor (like lisinopril) or ARB can paradoxically reduce amlodipine-associated oedema by raising venous tone. Reducing the dose may also help.

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Medical disclaimer

This page is for educational reference only. Always follow the dosage and instructions given by your prescriber or pharmacist. Do not start, stop, or change medicines without medical advice.

Reviewed 2026-06-01 · Looms Medical Team