Amlodipine

DHP Calcium Channel Blocker·Cardiovascular - Antihypertensives

Hypertension, chronic stable angina, Prinzmetal's (vasospastic) angina

PBSDHP-CCBNorvasc10 mg tabletS4+1

Max Dose

10 mg/day

Half-life

30-50 h

Peripheral Edema

HIGH RISK

Grapefruit

SAFE

Rapid Summary

Overview

Dihydropyridine (DHP) Calcium Channel Blocker. Pure, extremely potent peripheral vasodilator. Excellent for lowering blood pressure but notorious for causing swollen ankles.

Maximum Dose

Max 10 mg/day.

Clinical Focus

Unlike Verapamil/Diltiazem, Amlodipine has virtually zero effect on the heart rate or AV node. It strictly relaxes blood vessels.

Bottom Line

Amlodipine is a first-line antihypertensive with no monitoring burden and safe in most populations, but peripheral oedema is common and dose-limiting.

Formulation & Access

Brand Names

Norvasc

Oral Routes

Tablets (5, 10 mg). Often combined with Perindopril (Reaptan) or Valsartan (Exforge).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension, chronic stable angina, Prinzmetal's (vasospastic) angina.

Clinical Place

First-line antihypertensive, especially in elderly and Afro-Caribbean patients who respond poorly to ACE inhibitors.

Quick reference

Class & Role

DHP Calcium Channel Blocker — Dihydropyridine (DHP) Calcium Channel Blocker.

Route / Formulation

Tablets (5, 10 mg). Often combined with Perindopril (Reaptan) or Valsartan (Exforge). (Norvasc)

Usual Dose & Max

Start PO 5 mg OD. Titrate to Max 10 mg OD.

Key Indication Doses

Hypertension / Angina: Start PO 5 mg OD. Titrate to Max 10 mg OD. Elderly / Hepatic Impairment: Start at 2.5 mg OD. Clearance is severely delayed in liver disease.

Best Uses

Amlodipine is a first-line antihypertensive with no monitoring burden and safe in most populations, but peripheral oedema is common and dose-limiting.

Avoid / Cautions

Severe hypotension, cardiogenic shock, severe aortic stenosis (vasodilation will drop coronary perfusion fatally). Pregnancy Category C.

Key Risks

Cardiovascular: Severe peripheral edema (swollen, pitting ankles/legs). Extremely common at 10mg. HIGH — Flushing, palpitations, hypotension. Gastrointestinal: Gingival hyperplasia (swollen gums).

Key Interactions

CYP3A4 inhibitors (Clarithromycin, Ketoconazole) spike Amlodipine levels, worsening edema and hypotension. Unlike Felodipine, Amlodipine does NOT interact significantly with Grapefruit juice.

Monitoring

Check BP. Inspect the patient's ankles for severe pitting edema before escalating from 5mg to 10mg.

Clinical Pearl

If a patient on Amlodipine develops swollen ankles, prescribing Frusemide (a diuretic) will NOT fix it. The edema is caused by capillary hydrostatic pressure leaking fluid into the tissues, not by whole-body fluid overload. You must either halve the Amlodipine dose or add an ACEi (which dilates the venules to drain the fluid).

Access

Norvasc10 mg tablet

Brand: Norvasc
Formulation: Tablets (5, 10 mg)

Amlodipine

DHP Calcium Channel Blocker·Cardiovascular - Antihypertensives

Hypertension, chronic stable angina, Prinzmetal's (vasospastic) angina

PBSDHP-CCBNorvasc10 mg tabletS4+1

Max Dose

10 mg/day

Half-life

30-50 h

Peripheral Edema

HIGH RISK

Grapefruit

SAFE

Rapid Summary

Overview

Dihydropyridine (DHP) Calcium Channel Blocker. Pure, extremely potent peripheral vasodilator. Excellent for lowering blood pressure but notorious for causing swollen ankles.

Maximum Dose

Max 10 mg/day.

Clinical Focus

Unlike Verapamil/Diltiazem, Amlodipine has virtually zero effect on the heart rate or AV node. It strictly relaxes blood vessels.

Bottom Line

Amlodipine is a first-line antihypertensive with no monitoring burden and safe in most populations, but peripheral oedema is common and dose-limiting.

Formulation & Access

Brand Names

Norvasc

Oral Routes

Tablets (5, 10 mg). Often combined with Perindopril (Reaptan) or Valsartan (Exforge).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension, chronic stable angina, Prinzmetal's (vasospastic) angina.

Clinical Place

First-line antihypertensive, especially in elderly and Afro-Caribbean patients who respond poorly to ACE inhibitors.

Quick reference

Class & Role

DHP Calcium Channel Blocker — Dihydropyridine (DHP) Calcium Channel Blocker.

Route / Formulation

Tablets (5, 10 mg). Often combined with Perindopril (Reaptan) or Valsartan (Exforge). (Norvasc)

Usual Dose & Max

Start PO 5 mg OD. Titrate to Max 10 mg OD.

Key Indication Doses

Hypertension / Angina: Start PO 5 mg OD. Titrate to Max 10 mg OD. Elderly / Hepatic Impairment: Start at 2.5 mg OD. Clearance is severely delayed in liver disease.

Best Uses

Amlodipine is a first-line antihypertensive with no monitoring burden and safe in most populations, but peripheral oedema is common and dose-limiting.

Avoid / Cautions

Severe hypotension, cardiogenic shock, severe aortic stenosis (vasodilation will drop coronary perfusion fatally). Pregnancy Category C.

Key Risks

Cardiovascular: Severe peripheral edema (swollen, pitting ankles/legs). Extremely common at 10mg. HIGH — Flushing, palpitations, hypotension. Gastrointestinal: Gingival hyperplasia (swollen gums).

Key Interactions

CYP3A4 inhibitors (Clarithromycin, Ketoconazole) spike Amlodipine levels, worsening edema and hypotension. Unlike Felodipine, Amlodipine does NOT interact significantly with Grapefruit juice.

Monitoring

Check BP. Inspect the patient's ankles for severe pitting edema before escalating from 5mg to 10mg.

Clinical Pearl

Access

Norvasc10 mg tablet

Brand: Norvasc
Formulation: Tablets (5, 10 mg)