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Fact Checked

What Is the Best Time to Take Amlodipine?

High blood pressure is the “silent killer” in America, and increasing numbers of people are affected by the condition each year. About 45 percent of the American adult population, or 108 million people, has high blood pressure, also known as hypertension. High blood pressure is referred to as the “silent killer” because it is the most common cause of cardiovascular disease-related deaths in the United States, and because many people don’t experience any symptoms, they are unaware that they have the condition until it’s too late. Lifestyle factors, such as diet, exercise, stress level, weight, and more play a major role in the development of high blood pressure, so the first line of treatment for most cases of hypertension usually involves lifestyle changes.  It is common for physicians to recommend that patients with high blood pressure eat right, exercise more, and reduce stress, but lifestyle changes alone may not adequately manage high blood pressure in all situations. Some people require treatment with a blood pressure medication like amlodipine in order to manage their blood pressure in conjunction with lifestyle changes. Patients who need to take medication for their blood pressure want to be sure that they are taking their medication correctly, so one common question asked of doctors is, “What is the best time to take amlodipine?” 

What Is Amlodipine?

Amlodipine, the generic name for the brand name drugs Norvasc and Katerzia, belongs to a class of medications called calcium channel blockers as an antihypertensive drug.  Amlodipine was first patented in 1982 and has been approved for medical use in the United States by the Food and Drug Administration (FDA) since 1990. Amlodipine can be purchased in either its name brand or generic forms in the United States and is available by prescription only. 

What Conditions Are Treated With Amlodipine?

Amlodipine besylate is primarily used to treat high blood pressure, chest pain (angina) and other conditions caused by coronary artery disease or heart disease. Depending on the condition and the individual patient, amlodipine can be taken alone or with other medications to manage the patient’s blood pressure and heart conditions. People taking amlodipine are less likely to require hospitalization or surgery due to chest pain because the medication reduces the pain associated with angina. Patients with high blood pressure have a reduced risk of heart attack or stroke caused by hypertension when taking amlodipine.  

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Angina

Angina is the medical term for chest pain. The condition is typically experienced as pain, pressure, or tightness in the heart muscle cells, and it is often triggered by stress or physical activities like walking and other forms of exercise. Most people feel angina in the vascular smooth muscle in the chest, but some patients report pressure, tightness, or pain felt in other places, including the neck, jaw, shoulder, back, or either arm. During periods of vasospastic angina or variant angina, many patients experience symptoms that include shortness of breath, sweating, nausea, or lightheadedness, and heartburn. Angina is most commonly caused by decreased blood flow and oxygen to the heart that develops as a result of atherosclerosis, or narrowing of the blood vessels. If not treated properly, angina can increase the risk of heart attack or heart failure and become life-threatening due to low ejection fraction. 

High Blood Pressure

Blood pressure is measured as the force resulting from blood pushing against the walls of the blood vessels as the heartbeats. This force is how blood is sent to different areas of the body, delivering oxygen. 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. Hypertension, or high blood pressure, is considered dangerous because it results in an increased workload for the heart and blood vessels. Over time, the blood vessels and heart work less efficiently and must use more effort to send blood to the tissues and organs, which they need in order to function. 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.  High blood pressure can often be controlled with lifestyle changes and medication, but if not carefully 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. However, medication can help you achieve your blood pressure goals. 

How Does Amlodipine Work?

Calcium channel blockers like amlodipine work by blocking calcium from entering the heart and arteries. Calcium plays an important role in the body and is critical for good heart health, as it causes heart and arteries to contract more strongly. Most of the time, that’s a good thing, but people who have high blood pressure and angina experience an increase in symptoms when calcium enters the heart and arteries. Calcium channel blockers prevent calcium from entering the heart and arteries, which allows the blood vessels to relax and open. Some calcium channel blockers, including amlodipine, also slow the heart rate, which helps lower blood pressure further and can control an irregular heart and relieve pain associated with angina. 

What Is the Best Time to Take Amlodipine?

Although there are some medications that need to be taken at a certain time of day or under certain conditions in order to be effective, amlodipine is not one of them. Amlodipine can be taken at any time of the day and can be taken with or without food, but it should always be taken at the same time of day. Taking amlodipine at the same time each day helps to keep blood pressure levels even and makes treatment more effective. 

What Benefits Are Associated With Amlodipine?

Amlodipine has been extensively studied and has been used in the United States for more than 30 years. Therefore, one of the major benefits of amlodipine is that it has developed a reputation as a reliable, effective drug for treating high blood pressure and angina. Use of amlodipine has several additional benefits:

  • Children as young as six can receive treatment for high blood pressure with amlodipine.
  • The drug can be combined with other heart medications in patients who have multiple heart issues to address with a lower risk of drug interactions than other medications.
  • Amlodipine effectively reduces the signs and symptoms of angina and high blood pressure for many patients.
  • Because amlodipine is available in a generic form,  the medication is generally affordable and accessible for most patients.
  • The medication can be cut or crushed to make taking it easier for patients who have difficulty swallowing pills.

Are There Any Risks Associated With Amlodipine?

With a 30 year history of medical use in the United States, amlodipine is generally considered a safe medication. However, adverse events have been known to occur while taking amlodipine, so patients should exercise caution when using the medication. Although there are many benefits associated with amlodipine, as listed above, taking the medication also poses some risks. Risks associated with amlodipine include:

  • Patients with liver problems may need to take a lower dosage of the medication. Liver problems or liver disease can prevent the body from processing amlodipine quickly enough, which can cause the drug to build up in the bloodstream. When this occurs, patients are at an increased risk of experiencing side effects. 
  • Patients with heart problems may experience increased chest pain, low blood pressure, heart palpitations, or a heart attack after starting or increasing their dose of amlodipine. Patients with heart problems are considered at higher risk, so it’s important to discuss any existing heart conditions with your doctor.

What Dosage of Amlodipine Should I Take?

Your doctor will determine the right dose of amlodipine for you based on drug information and the condition being treated, your age, and several other factors. When used to treat hypertension in adults, doctors will typically start patients out on an initial dose of 5 mg of amlodipine taken once per day through oral administration. If the patient’s blood pressure is not brought under control within 7 to 14 days, the dose may be increased to a maximum of 10 mg per day as directed by the doctor. When used to treat hypertension in children between the ages of 6 and 17 and seniors over the age of 65, the starting dosage is 2.5 mg taken by mouth once per day. While children can bump up to a 5 mg dose if needed to control high blood pressure, elderly patients process drugs more slowly and should use a lower dosage if possible. 
When treating angina in adults, most patients begin with a starting dose of 5 mg of amlodipine taken once per day, with a maximum dose of 10 mg per day. Amlodipine is not authorized for the treatment of angina in children. 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.
Overall, be sure to follow the medical advice of your doctor including informing them about any missed doses and storing the medication at room temperature. 

What Side Effects Are Associated With Amlodipine?

Side effects associated with amlodipine are categorized as either common or serious. Common side effects associated with amlodipine that usually do not need medical attention include:

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

As long as these common side effects are mild, they should go away within a few days or weeks. If side effects persist or allergic reactions occur, 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

Is Amlodipine Safe to Use During Pregnancy and Breastfeeding?

Amlodipine is classified by the FDA as a Category C medication for pregnant women, meaning the use of the medication in pregnant women has not been conclusively studied through clinical trials. 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. If you are pregnant, speak with your doctor about taking amlodipine during pregnancy.

Studies indicate that use of amlodipine while breastfeeding has not caused adverse effects by passing into 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.

Are There Any Precautions Associated With Amlodipine?

Anyone who is allergic to amlodipine or other calcium channel blockers,  including nisoldipine or nifedipine, or any of the inactive ingredients of the medication should not take amlodipine. Patients should give their doctor their complete medical history, as well as a list of any prescription drugs, over-the-counter medications, vitamins, supplements, and herbs that you currently take, particularly if you have a history of any of the following:

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

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 July 13th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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