Amlodipine is a dihydropyridine calcium channel blocker used primarily to treat hypertension (high blood pressure) and to prevent angina (chest pain) due to coronary artery disease, including vasospastic (Prinzmetal) angina. By relaxing the smooth muscle in arterial walls, it reduces peripheral vascular resistance, lowers blood pressure, improves oxygen delivery to the heart muscle, and decreases the frequency of angina episodes.
Lowering blood pressure helps reduce the risk of stroke, heart attack, heart failure, and kidney problems when used as part of a comprehensive plan that may include diet, exercise, and other medications. Amlodipine is long-acting, typically taken once daily, and is often combined with other antihypertensives such as ACE inhibitors, ARBs, thiazide diuretics, or beta-blockers when additional blood pressure control is needed.
Brand-name amlodipine is known as Norvasc in some markets; many generic versions are available and are considered clinically equivalent when dispensed by a licensed pharmacy.
Follow your clinician’s directions exactly. The information below is general and may not apply to your situation. Do not change your dose without medical guidance.
Adults with hypertension or chronic stable/vasospastic angina: Typical starting dose is 5 mg once daily. Some patients—older adults, those of smaller body size, or individuals with hepatic impairment—may start at 2.5 mg once daily. The usual maintenance dose ranges from 5 to 10 mg once daily, with 10 mg being the maximum recommended daily dose.
Pediatrics (ages 6–17) with hypertension: 2.5 to 5 mg once daily. Doses above 5 mg daily have not been adequately studied in this age group. Safety and effectiveness are not established for children under 6 years.
Renal impairment: No routine dosage adjustment is needed; however, titrate carefully and monitor blood pressure and clinical response. Hepatic impairment: Because amlodipine is extensively metabolized in the liver, start low (e.g., 2.5 mg) and titrate slowly with close monitoring.
How to take it: Take amlodipine at the same time each day, with or without food. Swallow tablets whole with a glass of water. If your clinician prescribes a combination tablet (e.g., with an ARB or atorvastatin), follow the specific instructions for that product. Consistency matters: missing doses or stopping suddenly can lead to loss of blood pressure control or recurrence of angina.
Time to effect: Most people see partial blood pressure lowering within a week, with full effect in 2–4 weeks. Because amlodipine has a long half-life, dose adjustments should be spaced to allow time for the steady state to be reached and assessed.
- Low blood pressure risk: Amlodipine can cause symptomatic hypotension, particularly when starting therapy, increasing the dose, or combining with other blood pressure medications. Stand up slowly from sitting or lying positions. Report dizziness, fainting, or extreme fatigue.
- Worsening angina/MI: Rarely, especially in people with severe obstructive coronary disease, angina may worsen or myocardial infarction can occur during initiation or dose escalation. Seek urgent care for new or worsening chest pain, shortness of breath, or pressure radiating to the arm/jaw.
- Heart failure: Amlodipine is generally considered neutral in stable heart failure with reduced ejection fraction and may be used if indicated for angina or hypertension. In decompensated heart failure or when edema is problematic, careful monitoring is needed, and diuretic adjustments may be required.
- Peripheral edema: Dose-related ankle or foot swelling is common due to arteriolar dilation. It is typically not a sign of heart failure when occurring in isolation with normal heart function, but report significant swelling to your clinician; a dose change or adding an ACE inhibitor/ARB may help.
- Liver disease or older age: Reduced clearance can increase drug exposure. Start at a lower dose and titrate cautiously.
- Pregnancy and breastfeeding: Limited data exist in pregnancy; discuss risks and benefits with your obstetric provider. In lactation, small amounts appear in breast milk; many guidelines consider amlodipine compatible with breastfeeding, but individualized assessment is recommended.
- Dentistry and oral health: Gingival enlargement can occur with long-term use. Good oral hygiene and dental checkups can reduce risk. Report gum changes early.
- Driving and machinery: Until you know how amlodipine affects you, use caution operating machinery or driving, especially if you feel dizzy or lightheaded.
- Known hypersensitivity to amlodipine or any component of the formulation.
- Severe hypotension, shock (including cardiogenic shock), or hemodynamic instability.
- Use caution, with specialist guidance, in severe aortic stenosis or obstructive outflow conditions where fixed cardiac output can make vasodilation poorly tolerated.
Your clinician will assess the balance of risks and benefits based on your cardiovascular status and concurrent conditions.
Common (often dose-related): Swelling of the ankles or feet (peripheral edema), flushing, headache, dizziness or lightheadedness, fatigue, and palpitations. Many of these improve after the first few weeks as your body adjusts or after a dose optimization.
Gastrointestinal: Nausea, abdominal discomfort, or constipation can occur but are usually mild. Maintaining hydration and a balanced diet may help.
Oral/dental: Gingival hyperplasia (overgrowth of gum tissue) is an uncommon but recognized effect with dihydropyridine calcium channel blockers. Good oral hygiene and routine dental visits mitigate risk; dose adjustment may be needed if it occurs.
Less common: Sleep disturbances, rash, muscle cramps, or joint pain. Peripheral neuropathy-like symptoms are rare and warrant evaluation if persistent.
Serious but rare: Worsening chest pain, signs of myocardial infarction (severe chest pressure, sweating, shortness of breath), severe hypotension with fainting, significant liver injury (yellowing of skin/eyes, dark urine, right upper abdominal pain), or severe allergic reactions (facial swelling, hives, trouble breathing). Seek emergency care immediately if any of these occur.
Report side effects promptly. Never stop amlodipine abruptly without medical advice, especially if you’re taking it for angina or severe hypertension.
Amlodipine is metabolized by CYP3A4. Drugs and supplements that affect this enzyme can alter amlodipine levels. Always provide your clinician and pharmacist a complete list of prescription drugs, OTC medications, and supplements.
CYP3A4 inhibitors (can increase amlodipine levels and side effects): Macrolide antibiotics such as clarithromycin and erythromycin; azole antifungals like ketoconazole, itraconazole, and voriconazole; certain antivirals (e.g., ritonavir-boosted regimens); some calcium channel blockers; and grapefruit in large amounts (clinical impact is usually modest for amlodipine but caution is reasonable). Monitor for hypotension and edema; dose adjustments may be needed.
CYP3A4 inducers (can decrease amlodipine effectiveness): Rifampin, carbamazepine, phenytoin, phenobarbital, and St. John’s wort. Blood pressure may rise if amlodipine levels drop. Your clinician may adjust therapy or choose alternatives.
Statins: Amlodipine can increase exposure to simvastatin. When used together, simvastatin should generally be limited to 20 mg daily. Other statins (e.g., atorvastatin, rosuvastatin) have fewer clinically significant interactions but still require monitoring.
Immunosuppressants: Amlodipine may raise levels of tacrolimus and cyclosporine in some patients. Trough levels should be monitored and doses adjusted as directed by the transplant or specialty team.
Additive blood pressure lowering: ACE inhibitors, ARBs, thiazides, beta-blockers, alpha-blockers, nitrates, and PDE5 inhibitors (e.g., sildenafil) can enhance hypotensive effects. This is often intentional, but monitor for dizziness or fainting, especially when starting or titrating.
Alcohol and cannabis: Both can enhance dizziness and orthostatic hypotension. Use cautiously and avoid activities requiring alertness until you know your response.
This is not a complete list. Consult your pharmacist for a personalized interaction check before starting or stopping any medication or supplement.
If you miss a dose, take it as soon as you remember the same day. If it’s almost time for your next dose, skip the missed dose and resume your regular schedule. Do not double up to “catch up,” as this increases the risk of hypotension and side effects. To help avoid missed doses, tie your medication to a daily routine and consider a pill organizer or reminders.
Amlodipine overdose can cause significant hypotension, reflex tachycardia, dizziness, fainting, and, in severe cases, shock. If an overdose is suspected, call emergency services immediately. Do not attempt to self-treat.
Medical management is supportive: airway and breathing support, intravenous fluids, vasopressors (as needed), calcium administration in some cases, and close cardiac monitoring. Because amlodipine is highly protein bound, hemodialysis is unlikely to be useful. If ingestion was recent, activated charcoal may be considered in a medical setting.
Store amlodipine tablets at room temperature (generally 20–25°C/68–77°F) in a dry place away from direct heat and moisture. Keep in the original, tightly closed container and out of reach of children and pets. Do not use tablets past the expiration date. Ask your pharmacist about proper disposal of unused or expired medication—do not flush unless instructed.
In the United States, amlodipine is a prescription-only medication. It is both unsafe and illegal to buy amlodipine without a valid prescription from a licensed clinician. Any website or service offering amlodipine without a prescription should be avoided, as such sources may sell counterfeit or substandard products and bypass essential safety checks like interaction screening and dose verification.
Safe, legal access: Schedule an in-person visit with your primary care clinician or a cardiology specialist, or use a reputable telehealth service staffed by U.S.-licensed clinicians. If amlodipine is appropriate, they will provide a valid prescription that can be filled at a state-licensed pharmacy. When shopping online, verify that the pharmacy is licensed in your state and consider resources like your state board of pharmacy or the National Association of Boards of Pharmacy to identify safe providers.
Cost and coverage: Many insurance plans and discount programs cover generic amlodipine at low cost. Ask your pharmacist about therapeutic alternatives, combination tablets (if suitable), and price-matching policies to keep treatment affordable—without compromising safety or legality.
Bottom line: Do not attempt to obtain amlodipine without a prescription. Work with licensed healthcare professionals and pharmacies to ensure the right diagnosis, the right dose, and safe, effective treatment.
Amlodipine is a dihydropyridine calcium channel blocker that relaxes blood vessel walls by blocking L-type calcium channels, reducing peripheral vascular resistance and lowering blood pressure with once-daily dosing due to a long half-life (about 30–50 hours).
It is used to treat hypertension, chronic stable angina, and vasospastic (Prinzmetal) angina; it’s also sometimes used off-label for Raynaud’s phenomenon when other options are unsuitable.
Blood pressure starts to improve within 6–8 hours, with a steadier effect after a few days and full effect typically reached in 1–2 weeks as steady state is achieved.
Most adults start at 5 mg once daily and adjust to 2.5–10 mg based on response and tolerance; older adults and those with liver impairment often start at 2.5 mg; for children 6–17 years, 2.5–5 mg once daily is typical.
Ankle or leg swelling (peripheral edema), flushing, headache, dizziness, fatigue, palpitations, and occasionally nausea or gingival (gum) overgrowth; serious reactions are rare but include severe dizziness or fainting from low blood pressure.
It dilates small arteries more than veins, increasing capillary pressure and shifting fluid into tissues; this is not true fluid retention and is usually not dangerous, but it can be uncomfortable; lowering the dose, combining with an ACE inhibitor or ARB, leg elevation, compression, and reducing salt intake can help.
Take it when you remember unless it’s near the time for the next dose; if so, skip the missed dose and resume your regular schedule—do not double up.
There is no classic “rebound” like with beta blockers, but your blood pressure can rise; talk to your clinician before stopping or switching, and taper if advised.
Yes—CYP3A4 inhibitors (like clarithromycin, azole antifungals) can raise amlodipine levels; inducers (like rifampin, St. John’s wort) can lower them; limit simvastatin to 20 mg daily when used with amlodipine; combining with other blood pressure medicines can increase the risk of dizziness or low blood pressure.
No dose change is usually needed in kidney disease; in liver impairment, start low and titrate carefully since the drug is metabolized by the liver.
In pregnancy, nifedipine ER and labetalol are generally preferred; amlodipine may be continued when benefits outweigh risks—discuss with your obstetric clinician; during breastfeeding, only small amounts pass into milk and it’s generally considered compatible.
Take it at the same time every day; morning or evening both work because it lasts 24 hours; some people prefer evening if daytime dizziness or morning if evening swelling is bothersome—consistency matters most.
Alcohol can enhance dizziness or flushing—moderate your intake; large or frequent amounts of grapefruit juice may modestly increase amlodipine levels, so it’s best to avoid or limit it.
It usually has little effect on resting heart rate; some people notice mild palpitations initially; most can exercise as usual once blood pressure is controlled.
Check blood pressure and pulse regularly, watch for swelling, dizziness, or headaches, and keep good dental hygiene to reduce the risk of gum overgrowth; routine blood tests are not usually required unless other conditions or medicines warrant it.
Confirm it’s not due to another cause (such as a vein issue or heart problem), consider lowering the dose, switching to a different calcium channel blocker, or adding an ACE inhibitor/ARB, and reduce salt intake; talk to your clinician if swelling is persistent, painful, or one-sided.
Amlodipine is generally safe in heart failure with reduced ejection fraction, though it is not a heart failure treatment; monitor for swelling; non-dihydropyridine calcium channel blockers like verapamil or diltiazem are typically avoided in reduced ejection fraction.
Standard tablets can be split if scored; do not crush if your prescriber or pharmacist advises against it due to formulation specifics; there is no common extended-release version of amlodipine in many markets, but verify your product.
Decongestants like pseudoephedrine can raise blood pressure; NSAIDs may blunt blood pressure control; St. John’s wort can lower amlodipine levels; always review supplements with your clinician.
Limit sodium, maintain a healthy weight, stay active, moderate alcohol, and follow a heart-healthy diet; these steps enhance blood pressure control and may allow lower doses.
Both lower blood pressure effectively, but amlodipine’s longer half-life provides smoother 24-hour control and less reflex tachycardia; nifedipine is typically used as an extended-release tablet and is preferred in pregnancy, while immediate-release nifedipine is avoided for chronic use.
Both can cause edema, but many clinicians find edema rates similar; individual response varies, and some patients tolerate felodipine slightly better—dose adjustment or adding an ACE inhibitor/ARB often matters more than the specific agent.
Both are once-daily dihydropyridines, but lercanidipine is very lipophilic and often taken before meals; some patients experience less flushing and edema on lercanidipine, though interactions via CYP3A4 are similar; availability and cost can differ by region.
Use amlodipine primarily for hypertension and angina when you don’t need heart rate control; use diltiazem when rate control is needed (for example, in atrial fibrillation) or for angina with high heart rate; diltiazem can slow heart rate and interact more strongly with other drugs.
Amlodipine mainly dilates blood vessels without slowing the heart; verapamil lowers blood pressure, slows heart rate, and treats arrhythmias but can cause constipation and should be avoided in heart failure with reduced ejection fraction; verapamil has more significant drug interactions.
Both relieve angina by reducing afterload and coronary spasm; amlodipine’s steady 24-hour effect and minimal heart rate impact make it a common first choice; nifedipine ER is an alternative, especially in pregnancy or when amlodipine isn’t tolerated.
Amlodipine is an oral, once-daily option for chronic control; nicardipine is often used intravenously for acute hypertension or orally multiple times per day—amlodipine is more convenient for long-term therapy.
Clevidipine is an intravenous, ultra–short-acting calcium channel blocker used in perioperative or ICU blood pressure control; amlodipine is for chronic outpatient management.
Yes; verapamil and diltiazem are stronger CYP3A4 and P-glycoprotein inhibitors with many interactions and stricter simvastatin limits (typically max 10 mg), while amlodipine is a weaker inhibitor with a simvastatin limit of 20 mg.
Amlodipine’s longer half-life provides steadier 24-hour control and is more forgiving if a dose is late; isradipine is effective but less commonly used and may require more frequent dosing.
Gingival hyperplasia can occur with any calcium channel blocker; it has been reported more often with nifedipine and verapamil than with amlodipine, though good dental hygiene reduces the risk with all.
Edema is a class effect; amlodipine, nifedipine, and felodipine can cause it, while some patients experience less edema with lercanidipine or lacidipine; combining with an ACE inhibitor or ARB reduces edema across the class.
Amlodipine is generally safe in reduced ejection fraction heart failure; diltiazem may worsen outcomes in reduced ejection fraction and is avoided in significant conduction disease without a pacemaker due to bradycardia risk.
Nifedipine extended-release has more pregnancy-specific data and is typically preferred; amlodipine may be continued if already effective and alternatives are unsuitable, under obstetric guidance.
Amlodipine is widely available as a low-cost generic and often the most economical once-daily option; some alternatives may be pricier or less widely available, depending on region and insurance.
