Amlodipine - Uses, Side Effects, Dosage, Precautions, And Interactions

Overview:

Amlodipine is a calcium channel blocker used to treat high blood pressure and angina (chest pain). The drug is food, and drug administration (FDA) approved and helps to prevent heart diseases. Amlodipine is available only with a prescription from a doctor.

What Is Amlodipine Used to Treat?

Amlodipine is used to treat high blood pressure, chest pain, and blocked arteries of the heart in coronary artery disease. Amlodipine is available alone or in combination with other hypertensives.

Amlodipine is a calcium channel blocker class and is a prescription choice for treating hypertension. In addition, it is used to treat and prevent angina resulting from coronary spasms and exertion.

How Does Amlodipine Work?

Amlodipine is a calcium ion antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and the cardiac muscles selectively. The contractions of the cardiac muscle depend upon the movement of extracellular calcium ions into these cells through specific ion channels. Amlodipine is a peripheral arterial vasodilator. It acts directly on vascular muscle to cause a reduction in blood pressure and peripheral vascular resistance.

The onset of the effect of Amlodipine after oral administration is gradual and produces peak plasma concentration six to eight hours after the first dose. The bioavailability is between 64 % to 90 % and is not altered by the presence of food. Amlodipine is converted to inactive metabolites (90%) in the liver, parent compound (10 %), and 60% of the metabolites excreted in the urine.

What Are the Side Effects of Amlodipine?

Some of the common side effects of Amlodipine include

• Dizziness.

• Drowsiness.

• Feeling tired.

• Stomach pain.

• Edema.

• Nausea.

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• Flushing.

• Erectile dysfunction.

• Joint pain.

• Weight gain.

Amlodipine may cause serious effects, including

• Pounding heartbeats.

• Fluttering in your chest.

• Worsening chest pain.

• Swelling in your feet or ankles.

• Severe drowsiness.

• Lightheadedness.

What Is the Dosage of Amlodipine?

The dosage of Amlodipine depends on the patient's condition and how well they respond to the treatment. Amlodipine is available in suspensions, capsules, and tablets in strengths including 2.5, 5, and 10 mg.

The dosage is started at 2.5 mg for the elderly, fragile, and patients with hepatic insufficiency. However, the maximum dose should be at most 10 mg daily in adults and 5 in children.

How to Take Amlodipine?

Amlodipine is usually taken once a day and should be ensured to be taken around the same time every day, either morning or evening. It is taken with or without food. Swallow the medicine whole with a glass of water. The suspension should be measured using a dosing syringe. All medicines should be taken as directed by the doctor.

What if You Miss a Dose of Amlodipine?

If you miss the dose of Amlodipine, take it as soon as you remember- unless it is time for the next dose. Do not take two tablets together.

What Would Happen If I Overdose on Amlodipine?

An overdose of Amlodipine may produce prolonged hemodynamic effects and lead to pulmonary edema. Symptoms can include dizziness, lightheadedness, fainting, and a fast heart rate. Due to its long elimination, patients should receive aggressive decontamination therapy. In addition, if the hemodynamics are unstable, continuous monitoring and supportive care are required.

Can Amlodipine Be Taken With Other Antihypertensive Drugs?

Amlodipine oral tablets are used with other drugs that treat high blood pressure, coronary artery disease, and angina.

• For High Blood Pressure:

  • Angiotensin-converting enzyme inhibitors such as

    • Lisinopril.

    • Benazepril.

  • Angiotensin II receptor blockers such as

    • Valsartan.

    • Losartan.

• For Coronary Heart Disease and Angina:

  • Beta-blockers such as

    • Metoprolol.

    • Bisoprolol.

  • Nitrates such as

    • Nitroglycerin.

    • Isosorbide mononitrate.

What Precautions Need to Be Taken When Taking Amlodipine?

Before taking Amlodipine, it is advised to tell the doctor about your medical history and the medications you are taking.

• Pregnancy and Breastfeeding - Taking Amlodipine during pregnancy may cause high blood pressure and result in complications such as eclampsia, gestational diabetes, premature delivery, and other complications. It is essential to monitor blood pressure in pregnant women. The drug may be present in breast milk.

• Allergies - Amlodipine causes severe allergic reactions to people allergic to it or other calcium channel blockers such as Nifedipine.

• Heart Problems - Heart problems like coronary heart disease and aortic stenosis may raise the risk of low blood pressure and heart attack after taking Amlodipine.

• Elderly - Older people may be more sensitive to the effects of Amlodipine and its side effects, such as dizziness. Hence, it should be administered with caution and dose adjustment.

• Alcohol - Drinking alcohol with Amlodipine may lower blood pressure than needed and cause headaches or dizziness.

• Work Requiring Mind Alertness - It is advised not to drive or handle machinery when taking Amlodipine, as the drug makes you dizzy.

• Liver Disease - As the drug is mainly metabolized in the liver, there is a potential for drug accumulation in patients with hepatic impairment.

• Pediatrics - Amlodipine should not be advised for children under six.

What Are the Drug Interactions of Amlodipine?

Drug interactions can alter the drug's efficacy and increase the risk of side effects. Hence, discussing your medications and medical conditions with the doctor is advised.

1. Drug Interactions:

• Simvastatin.
• CYP3A4 inhibitors such as Diltiazem, Ketoconazole, Itraconazole, and Ritonavir
• Cyclosporine.
• Sildenafil.

2. Disease Interactions:

• Liver Disease -The calcium channel blockers are metabolized in the liver. Patients with severe hepatic impairment have the potential for drug accumulation, so Amlodipine should be cautiously administered.
• Congestive Heart Failure - Care is taken in patients with acute myocardial infarction as it may worsen with the administration of calcium channel blockers.
• Coronary Heart Disease -Calcium channel blockers can increase angina's frequency, duration, and severity.
• Shock - Amlodipine should not be used in patients with hypotension systolic pressure as it may further depress cardiac outputs.

3. Food Interactions:

• Multivitamins - Using Amlodipine with multivitamins and minerals can decrease the drug's efficacy.
• Grapefruit - Consumption of grapefruit juice may increase the plasma concentration of Amlodipine.
• Pleurisy Root - Due to the glycoside content of pleurisy, roots are not recommended with cardiovascular medications.
• Sodium-Rich Foods - Low sodium food is advised for people on Amlodipine.

Conclusion:

Amlodipine is the first choice of antihypertensive medication to treat high blood pressure. It is a calcium channel blocker that helps to lower the risk of heart attacks and stroke. The medication should be stored at room temperature and kept out of reach of children. The medicine is used for long-term treatment and can cause serious side effects if not taken as prescribed. Patients must discuss their concerns regarding the medication's dosage, interactions, and precautions with their doctor before taking it.