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Amlodipine Besylate

Amlodipine

Amlodipine is a calcium channel blocker approved by the FDA to manage high blood pressure and angina. It works by preventing calcium from entering certain cells of the heart and blood vessel walls, enhancing blood flow and reducing blood pressure. This medication is taken once daily and can be combined with other treatments like diet and exercise. It is crucial for patients, especially those with liver disease or severe coronary conditions, to discuss their health history with their doctor to ensure safe usage. Side effects may include dizziness, swelling, and, in rare cases, severe allergic reactions. Follow your doctor’s instructions closely and continue taking Amlodipine even if you feel well, as high blood pressure often shows no symptoms.

Product Overview

Amlodipine is a medication classified under calcium channel blockers, primarily prescribed to treat high blood pressure (hypertension) and angina, a type of chest pain associated with heart disease. By blocking calcium from entering specific cells in the heart and blood vessel walls, Amlodipine helps relax the blood vessels, allowing blood to flow more easily and reducing the heart’s workload. The drug is typically administered once daily, with or without food, and is available in 2.5 mg, 5 mg, and 10 mg oral tablets. Dosage may vary based on age, existing health conditions, and response to treatment, with a typical adult starting dose ranging from 2.5 mg to 5 mg. Patients with severe liver problems or older adults might require lower doses due to slower drug metabolism.

It’s important for patients to adhere to the prescribed regimen and not to discontinue the medication without consulting their healthcare provider, even if they feel well. High blood pressure often shows no symptoms, and abrupt discontinuation can exacerbate conditions. While Amlodipine is generally well-tolerated, it can cause side effects like abdominal pain, dizziness, swelling of legs or ankles, and, in rare cases, severe allergic reactions.

Patients are advised to avoid alcohol, which can enhance side effects, and to monitor for any unusual symptoms, particularly when starting the drug or adjusting the dose. Patients should disclose all medications they are currently taking to avoid potential interactions, especially with drugs like simvastatin or certain antifungals, which can increase Amlodipine levels in the blood, raising the risk of side effects. This medication is effective in managing hypertension and angina, and it improves heart health when used correctly and under medical supervision.

Uses of Amlodipine

Amlodipine is commonly prescribed to treat the following conditions:

  • It helps to lower blood pressure, reducing the risk of stroke and heart attack.
  • Coronary Artery Disease
  • Angina is caused by reduced blood flow to the heart.

Additionally, this medication may be used to treat other conditions as determined by your healthcare provider.

How to Use Amlodipine?

Dosage

It comes in the form of oral tablets and has the following strengths: 

  • Amlodipine 2.5 mg tablets
  • Amlodipine 5 mg tablets
  • Amlodipine 10 mg tablets

Recommended Dosage for Different Patients

Dosage for High Blood Pressure (Hypertension)

  • For Adult
      • Starting Dosage (18 to 64 years): Typically, 2.5 mg to 5 mg taken orally once a day.
      • Dosage Adjustments: Your doctor may adjust your dosage depending on how well your blood pressure is controlled. If it remains high after 7 to 14 days of treatment, your doctor might increase your dosage.
    • Maximum Dosage: Up to 10 mg per day.
  • For Child
      • Typical Dosage (6 to 17 Years): 2.5 mg to 5 mg taken by mouth once per day. Doses over 5 mg have not been studied in children and are generally not recommended.
      • Typical Dosage (0 to 5 Years): This medication is generally not prescribed for children younger than 6 years.
  • For Senior
    • Typical Dosage (65 Years & Older): 2.5 mg taken orally once per day.
    • Note: Older adults may metabolize drugs more slowly, which can cause higher drug levels in the body than intended. Seniors might need a lower dosage to compensate for this.

Dosage for Coronary Artery Disease & Angina

  • For Adult
      • Starting Dosage (18 to 64 Years): Typically, 5 mg taken orally once a day.
      • Maximum Dosage: Up to 10 mg per day.
  • For Child
      • Typical Dosage (0 to 17 Years): There is no recommended dosage for children for this condition.
  • For Senior 
    • Typical Dosage (65 Years & Older): 5 mg taken by mouth once per day.
    • Note: Older adults may metabolize drugs more slowly. This can cause higher levels of Amlodipine in the body than intended. Seniors might need a lower dosage to ensure safety and effectiveness.

Special Dosage Considerations for People with Liver Disease

  • Recommended Dosage: The suggested dosage for individuals with liver disease is 2.5 mg, taken orally once per day.
  • Note: Amlodipine is processed by your liver. If your liver function is impaired, Amlodipine may remain in your body longer, increasing the risk of side effects. Those with severe liver issues may require an even lower dosage to avoid potential complications.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

  • Take Amlodipine exactly as your doctor has prescribed. 
  • Make sure to follow all the directions on your prescription label and review any medication guides or instruction sheets provided. Your doctor may change your dose occasionally based on your condition.
  • Amlodipine is typically taken once per day.
  • Take the medication at the same time each day, which can be with or without food.
  • If you are taking the oral suspension (liquid) form of Amlodipine, shake the bottle well before each use. Measure your dose using the measuring device that comes with the medicine, not a regular kitchen spoon.
  • Your blood pressure should be checked regularly.
  • If you are taking Amlodipine for high blood pressure, continue using it even if you feel fine. High blood pressure often does not have noticeable symptoms.
  • Do not alter your doses or stop taking any of your medications without consulting your doctor.
  • Your treatment plan may also include lifestyle changes such as diet, exercise, weight management, and regular blood tests.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Amlodipine Work?

Amlodipine is a type of medication called a calcium channel blocker. This group of medications works in a similar manner and is often used to treat similar health issues. It prevents calcium from entering specific tissues and arteries, allowing them to relax. This relaxation helps blood flow more easily to your heart, which helps lower your blood pressure and reduces your risk of having a heart attack or stroke. If you are taking Amlodipine for chest pain, it also lowers the likelihood of needing hospitalization or surgeries related to chest pain.

This medication begins to work immediately after you take your first dose. However, it might take several days before you feel the full effects of the drug in lowering your blood pressure or alleviating chest pain. With consistent daily use, the effects of Amlodipine generally last for about 24 hours. The benefits of Amlodipine will continue as long as you take the medication as directed by your doctor. If your doctor advises you to stop taking Amlodipine, the drug usually remains in your system for about 10 days after the last dose. You may still feel the effects of Amlodipine during this 10-day period after stopping the medication.

Important Safety Information

Side Effects

Common side effects of Amlodipine may include:

  • Abdominal pain
  • Dizziness
  • Feeling sleepy
  • Hot or warm feeling in your face (flushing)
  • Nausea
  • Swelling of your legs or ankles
  • Tiredness
  • Very fast heart rate (palpitations)

Serious side effects of Amlodipine may include:

  • Low blood pressure symptoms may include:
    • Lightheadedness
    • Fainting
    • Severe dizziness
  • A heart attack or more chest pain symptoms may include:
    • Shortness of breath
    • Nausea
    • Upper body discomfort
    • Chest pain or discomfort
    • Breaking out in a cold sweat
    • Unusual tiredness
    • Lightheadedness

[Note: This list may not cover all possible side effects. Always consult with your healthcare provider for medical advice about side effects.]

Warnings

  • For People with Liver Problems: Amlodipine is broken down by your liver. If your liver function is impaired, Amlodipine may stay in your body for a longer time, increasing the likelihood of side effects. If you have severe liver issues, your doctor might reduce your dosage to help manage this risk.
  • For People with Severe Obstructive Coronary Artery Disease: If you have severe obstructive coronary artery disease, your arteries are very narrow, which reduces blood flow and increases the risk of serious issues like heart attacks or worsening angina (chest pain). In rare instances, starting Amlodipine or increasing the dose may further elevate this risk. If you have this condition, your doctor might start you on a low dosage of Amlodipine and monitor your treatment closely, or they may suggest a different treatment approach.
  • For People with Severe Aortic Stenosis: Severe aortic stenosis is a condition where one of your heart valves is very narrow, reducing blood flow to your body. If you have this condition, taking Amlodipine could cause your blood pressure to drop too low. Your doctor might prescribe a lower dose of Amlodipine and monitor your condition closely during treatment, or they might suggest an alternative treatment.
  • Allergy Warning: Amlodipine can cause severe allergic reactions. If you experience any of these symptoms, call 911 or go to the nearest emergency room immediately. If you’ve had an allergic reaction to Amlodipine in the past, do not take this drug again, as taking it could be fatal. Symptoms include:
    • Swelling of your throat or tongue
    • Trouble breathing
    • Hives

Boxed Warning

Amlodipine/valsartan comes with a black box warning, the most stringent warning issued by the Food and Drug Administration (FDA). This warning is meant to alert doctors and patients to potential severe risks associated with the medication.

  • Pregnancy Risks: Do not take Amlodipine/valsartan if you are pregnant. If you are currently taking this medication and discover you are pregnant, discontinue its use immediately and consult your doctor. This medication can cause serious problems, including potential termination of the pregnancy.

Precautions

  • Before starting Amlodipine besylate, make sure to tell your doctor if you have congestive heart failure or liver disease.
  • Drinking alcohol can lower your blood pressure further and may increase certain side effects of Amlodipine.
  • If you are being treated for high blood pressure, continue using Amlodipine even if you feel well, as high blood pressure often shows no symptoms. You may need to use blood pressure medication for the rest of your life.
  • Amlodipine should be used as part of a complete treatment program that may also include diet, exercise, weight control, and possibly other medications. Adhere closely to your prescribed diet, medication schedule, and exercise routines.
  • Tell your doctor about all other heart or blood pressure medications you are currently taking.
  • Your chest pain may worsen when you first start taking Amlodipine or when your dose is increased. If your chest pain is severe or ongoing, contact your doctor immediately.
  • Do not take Amlodipine if you are allergic to it.
  • To ensure Amlodipine is safe for you, inform your doctor if you have ever had:
    • Liver disease.
    • Severe narrowing of the aortic valve (aortic stenosis) or other heart problems.
    • Coronary artery disease (clogged arteries).

Other Important Precautions

  • For Pregnant People: Studies in animals have shown adverse effects on the fetus when the mother is given Amlodipine. However, there have not been sufficient studies in humans to fully understand how the drug might affect a human pregnancy. If you are pregnant or planning to become pregnant, inform your doctor. Amlodipine should only be used during pregnancy if the potential benefits to the mother outweigh the potential risks to the fetus.
  • For Older Adults (Seniors): As you age, your body may not process drugs as efficiently as it used to. This can lead to higher levels of Amlodipine in your body for a longer period, increasing the risk of side effects.
  • For People Who Are Breastfeeding: Research indicates that Amlodipine can pass into breast milk, but it is not clear if it can cause side effects in a breastfed child. If you are breastfeeding, discuss with your doctor whether you should continue breastfeeding or discontinue the medication.
  • For Children: Amlodipine is generally not prescribed for children younger than 6 years.

Missed Dose

  • If you forget to take a dose of Amlodipine, you should take it as soon as you remember. 
  • If more than 12 hours have passed since your scheduled dose time, skip the missed dose and continue with your next dose at the regular time. 
  • If you are unsure about whether to skip the dose or take it, consult with your doctor or pharmacist for guidance.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

If you accidentally take too much Amlodipine, you might experience extremely low blood pressure, which can be dangerous. The symptoms of an overdose may include:

  • Lightheadedness
  • Fainting
  • A very fast heart rate
  • Dizziness

If you believe you have taken too much Amlodipine, contact your doctor or get in touch with America’s Poison Centers. However, if your symptoms are severe, call 911 or go immediately to the nearest emergency room. There is no specific antidote for an overdose of Amlodipine. Treatment involves managing the symptoms and side effects that occur as a result of the overdose.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

  • Store Amlodipine at room temperature, ideally between 59°F and 86°F (15°C and 30°C).
  • Keep the medication in its original container and ensure it is tightly closed to protect it from moisture.
  • Protect this drug from light by storing it in a dark place.
  • Avoid storing this medication in moist or damp areas, such as bathrooms, to prevent degradation.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Amlodipine Interactions

Amlodipine is an oral medication that can interact with other medicines, vitamins, or herbs you might be using. An interaction occurs when another substance affects how a medication works, which can be harmful or prevent the medication from being effective. To minimize the risk of interactions, it’s essential to inform your doctor about all the medicines, vitamins, or herbs you’re currently taking. Discuss with your doctor or pharmacist to understand how Amlodipine might interact with other substances you are taking. Common interactions include: 

  • Heart Medications (Diltiazem): Taking diltiazem with Amlodipine can increase the amount of Amlodipine in your body, potentially leading to more side effects.
  • Antifungal Medications: Using Amlodipine with certain antifungal drugs can also raise the levels of Amlodipine in your blood, increasing the likelihood of side effects. Some of these drugs include:
    • Itraconazole
    • Ketoconazole
    • Voriconazole
  • Antibiotics (Clarithromycin): This antibiotic can increase the amount of Amlodipine in your bloodstream, which might enhance the risk of side effects.
  • Medications for Erection Problems: Taking Amlodipine with drugs used to treat erectile dysfunction can increase your risk of low blood pressure (hypotension). Such medications include:
    • Tadalafil (Cialis)
    • Sildenafil (Viagra)
    • Vardenafil (Levitra)
    • Avanafil
  • Cholesterol Medication (Simvastatin): When taken with Amlodipine, the levels of simvastatin can increase, potentially heightening the risk of side effects from simvastatin.
  • Immunosuppressive Drugs: Taking Amlodipine with medications that control your immune system can lead to higher levels of these drugs in your body, increasing the chance of experiencing side effects. Examples include:
    • Tacrolimus
    • Cyclosporine (Neoral, Gengraf, Sandimmune)

[Note: This isn’t a complete list, and there could be other drugs that interact with Amlodipine. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Amlodipine Alternatives

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Frequently Asked Questions

Why should Amlodipine be taken at night?

Amlodipine can be taken either in the morning or at night; both times are equally effective. The vital factor is to take it at approximately the same time each day to maintain consistent levels of the medication in your body, which helps it work effectively. Additionally, taking Amlodipine at the same time as any other regular medications you have may make it easier to remember to take your dose.

Is 5mg Amlodipine enough to lower blood pressure?

For treating high blood pressure, the typical starting dosage for adults is 5 milligrams (mg) of Amlodipine once a day. However, some patients may begin treatment with a lower dose of 2.5 mg once daily, depending on their specific health needs and how they respond to the medication. Your doctor will monitor your blood pressure and may adjust your dosage if necessary to achieve the desired effect.

What is the primary purpose of Amlodipine?

Amlodipine is a calcium channel blocker medication used to treat high blood pressure (hypertension). Managing high blood pressure with Amlodipine helps prevent serious health issues like heart disease, heart attacks, and strokes in the future. Additionally, Amlodipine is used in order to avoid and manage chest pain (angina) associated with heart disease.

Does Amlodipine cause weight gain?

Weight gain has been reported by some individuals taking Amlodipine, though it is not a typical side effect. In fact, some people have reported weight loss while on medication. When weight gain does occur, it might be a sign of edema—fluid retention in the body. This fluid retention is often most noticeable in the ankles or lower legs. If you experience significant weight changes or swelling while taking Amlodipine, discussing these symptoms with your doctor is important.

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