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Fact Checked

Amlodipine side effects: What are they?

Over 108 million people, or 45 percent of American adults, are currently dealing with hypertension, or high blood pressure, whether they know it or not. Because high blood pressure doesn’t always cause symptoms and just so happens to be the most common cause of cardiovascular disease-related deaths in the United States, it’s known as the “silent killer” - many people have no idea they are affected until it’s too late. Lifestyle factors like poor diet, high-stress levels, not getting enough exercise, and not getting enough sleep all play a role in causing high blood pressure, but the condition can also be caused by other factors, such as medical conditions and certain medications. Lifestyle changes won’t control high blood pressure for everyone, and although they’re an important first step, sometimes treatment with medication is necessary.  One medication commonly prescribed to treat high blood pressure is amlodipine.

What Is Amlodipine?

Amlodipine is the generic name for a blood pressure medication sold under the brand names Norvasc and Katerzia. The drug belongs to a class of medications called calcium channel blockers and was first patented in 1982 and approved for medical use in the United States by the Food and Drug Administration (FDA) in 1990. Amlodipine is available by prescription only, but it can be purchased in either generic or brand name forms. 

What Conditions Are Treated by Amlodipine?

Amlodipine is primarily used to treat chest pain (angina), a condition commonly caused by coronary artery disease, and high blood pressure. The medication is considered highly useful because it can be taken in combination with other medications needed to manage heart conditions.  Taking amlodipine helps reduce the risk of hospitalization and surgeries caused by chest pain by lowering the pain caused by angina, and it also reduces the likelihood of suffering from a heart attack, heart failure, heart disease, or stroke caused by high blood pressure. 

What Is Angina?

Angina is a medical term for chest pain that is experienced as pain, pressure, or tightness and is usually brought on by stress or physical activity. While angina is commonly felt in the chest, some people experience pressure, pain, and tightness in other places, such as the neck, jaw, shoulder, back, or either arm. Angina can cause symptoms of shortness of breath, sweating, nausea, or lightheadedness, and heartburn. The condition often results from decreased blood flow and oxygen to the heart, which can be caused by a narrowing of the blood vessels called atherosclerosis. Suffering from angina increases a patient’s risk of heart attack and can be life-threatening if not treated. 

What Is High Blood Pressure?

High blood pressure is one of the most common medical conditions in the United States, and it is also one of the most deadly. The force at which blood pushes against the walls of the blood vessels as the heart beats determine how blood is sent to different areas of the body. When blood presses against the walls of the blood vessels too forcefully over a prolonged period of time, people can be diagnosed with high blood pressure. The condition causes the heart and blood vessels to work overtime because they become less efficient at sending blood to different parts of the body, requiring the heart to pump harder and more energy to be used. Lifestyle factors like diet, activity level, stress levels, and sleep can all play a role in blood pressure, and most people suffering from high blood pressure can control their condition with lifestyle changes. If not managed,  hypertension can cause a narrowing of the blood vessels by creating microtears in the walls of the arteries. The narrowing of the blood vessels further prevents blood from reaching the extremities, causing blood pressure to continue to rise. High blood pressure is the most common cause of cardiovascular disease-related death because it can lead to heart attack and stroke. The majority of high blood pressure cases have no obvious causes, such as medications or medical conditions, and are primarily influenced by lifestyle factors and genetics.  

Amlodipine Side Effects: What Are They?

Possible side effects associated with amlodipine are categorized as either common or serious, and the majority of common side effects do not require medical attention. Common side effects associated with amlodipine that usually do not need medical attention include:

  • Very fast heart rate (arrhythmia) or palpitations
  • Abnormal muscle movements
  • Tiredness or extreme sleepiness
  • Nausea
  • Irregular heart rate (arrhythmia)
  • Tremors
  • Swelling of the legs or ankles
  • Stomach pain or abdominal pain
  • Dizziness
  • Hot or warm feeling in the face/flushing

As long as these common side effects are mild, they should go away within a few days or weeks. If side effects persist or an allergic reaction occurs, talk to your doctor.

Some side effects of amlodipine do require medical attention. Check with your health care provider immediately if you experience any of the following serious side effects while taking amlodipine:

  • Increased chest pain or a heart attack. This side effect can occur when you first begin taking amlodipine or increase your dosage. Symptoms may include:
    • Lightheadedness
    • Upper body discomfort
    • Breaking out in a cold sweat
    • Nausea, chest pain or discomfort
    • Shortness of breath
    • Unusual tiredness
  • Low blood pressure, including:
    • Severe dizziness
    • Lightheadedness
    • Fainting

How Does Amlodipine Work?

Calcium channel blockers, the class of drugs to which amlodipine belongs, work by blocking calcium from entering the tissues of the heart, and arteries. Our bodies use calcium to direct the heart and arteries to contract more strongly, which helps to push blood through the blood vessels and out to different parts of the body. However, for people with high blood pressure, this causes blood pressure to increase even more. By blocking calcium from entering the heart and arteries, calcium channel blockers allow the blood vessels to relax and open, helping to lower blood pressure. Amlodipine also helps to slow the heart rate, which helps lower blood pressure further and can control an irregular heart and relieve pain associated with angina. 

What Are the Benefits of Using Amlodipine?

Use of amlodipine is associated with numerous benefits:

  • The medication has been used for several decades, is well studied, and has been proven effective. 
  • Amlodipine can be safely used to treat high blood pressure in children as young as six years of age.
  • The medication reduces the signs and symptoms of angina and high blood pressure for many patients.
  • Unlike some blood pressure medications, amlodipine can be safely combined with other heart medications in patients who have multiple heart issues to address.
  • Amlodipine can be cut or crushed to make swallowing it easier for patients and children with difficulty swallowing pills. 
  • Because amlodipine is available in a generic form,  the medication is generally affordable and accessible for most patients.

Are There Any Risks Associated with Amlodipine?

Amlodipine has been in use for decades and is generally well-tolerated, but some patients should exercise caution when taking the drug. Risks associated with amlodipine include:

  • People with severe liver problems may not process amlodipine quickly enough, causing the drug to build up in their symptoms over time. This can cause an increased risk of experiencing side effects, some of which can be serious. Patients with severe liver problems may need to take a lower dosage of the medication.
  • Patients with heart problems may experience low blood pressure, increased chest pain, or a heart attack after starting or increasing their dose of amlodipine. It’s important to discuss any existing heart conditions with your doctor.

What Dosage of Amlodipine Should I Take?

The recommended dose of amlodipine varies based on a patient’s age, the condition being treated, and other factors. Generally speaking, the starting dose of amlodipine for adults using the medication to treat hypertension is 5 mg taken once per day. In the event that 5 mg is not enough to control the patient’s blood pressure within 7 to 14 days, the dose may be increased to a maximum of 10 mg per day as directed by the doctor. For children between the ages of 6 and 17 and seniors over the age of 65 who are using amlodipine to treat hypertension, the starting dosage is 2.5 mg taken by mouth once per day. Amlodipine should be stored at room temperature and all other directions based on the drug information should be followed. 
Amlodipine is only approved for the treatment of angina in adults. Adults between the ages of 18 and 65 will generally receive a starting dose of 5 mg of amlodipine taken once per day, with a maximum dosage of 10 mg per day. Senior citizens over the age of 65 should take 5 mg by mouth once per day for the treatment of angina, as they may process the drug more slowly.

Is Amlodipine Safe for Pregnant and Breastfeeding Women?

The use of amlodipine in pregnant women has not been conclusively studied. Pregnant women with high blood pressure should get medical advice from their doctor before taking amlodipine during pregnancy. It is recommended that the medication be used during pregnancy only when clearly needed and when the benefits outweigh the risks to the unborn baby. 
Studies indicate that use of amlodipine while breastfeeding has not caused adverse effects from infants consuming breast milk, but caution should still be exercised if taking amlodipine while breastfeeding. Nursing mothers should speak to their doctors regarding the use of amlodipine while breastfeeding.

Who Should Not Take Amlodipine?

People who are allergic to amlodipine or other calcium channel blockers,  including nisoldipine or nifedipine, should not take amlodipine. Make sure to give your doctor a complete medical history and a list of any prescription drugs or over-the-counter drugs that you currently take, particularly if you have a history of any of the following:

  • Aortic stenosis, a structural heart problem
  • Very low blood pressure
  • Heart problems
  • Kidney problems, liver problems or liver disease

Taking amlodipine can make you feel dizzy. The use of alcohol or marijuana can increase these feelings because of drug interactions. You should not drive or do anything that requires alertness until you know how amlodipine affects you. 

Published May 8th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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