Amlodipine – Is it Safe? Uses, Side effects, Dosage

What is Amlodipine?

Amlodipine is a medicine which is used alone or in combination with other drugs to treat various medical conditions.

• This drug is into the class of drugs known as Calcium channel blocker.
• It is a synthetic dihydropyridine with antihypertensive and antianginal properties.
• It is primarily used in the management of Angina (Chest pain) and Hypertension (High blood pressure).
• But it is not directly used during the attack of chest pain like other drugs (such as sublingual nitroglycerin).
• It is available only with the prescription by the physician.

Amlodipine – Is it Safe? Uses, Side effects, Dosage

What is its Brand name(s)?
What is its composition?
How does Amlodipine work?
What are its uses?
How effective is this medicine?
Is it addictive?
What is the dosage?
What if I miss a dose?
What to do in case of overdosage?
What to do in case of allergic reactions?
Can I drive after taking it?
Can it be taken with food?
Can it be taken on an empty stomach?
Can it be taken with alcohol?
What are the side effects?
Does this medicine has any drug interactions?
Precautions
Is this safe to use if I am pregnant?
Is this safe to use if I am breastfeeding?
Can this medicine be given to Children and Infants?
Is this medicine available as over the counter (OTC) product?
Frequently asked questions
Reference

What is its Brand Name?

Its brand name is Norvasc.

What is its composition?

This medicine is composed of active ingredients such as Amlodipine along with Besylate, maleate and mesylate. According to this chemical composition, this drug available in other names as Amlodipine besylate, Amlodipine maleate and Amlodipine mesylate.

The other inactive ingredients present in this drug are

• Microcrystalline cellulose[1]
• Calcium phosphate[2] anhydrous
• Sodium starch[3] glycolate
• Magnesium stearate[4]

How does Amlodipine work?

This medicine being a calcium channel blocker, it works to treat high blood pressure[5]. It works by relaxing and widening the blood vessels[6] which would lower the level of blood pressure[7]. It would make the heart easier to pump the blood throughout the body.

Angina is the chest pain[8] occurs due to the hardening and narrowing of arteries[9]. It happens when blood supply is not enough for the muscles of the heart[10]. In the case of this condition, it works by increasing blood supply to the heart by broadening and smoothening the walls of the arteries.

What are its uses?

Amlodipine has the properties to be involved in the improvement, treatment and prevention of various medical conditions which are listed below,

• Angina[11] (chest pain) and decrease the frequency of angina attack
• Hypertension (High blood pressure)
• Coronary artery diseases such as Heart diseases and heart attack
• Stroke
• Increase the ability to exercise

How effective is this medicine?

Due to the active ingredient’s potency, the drug stimulates the rapid effect on the conditions to be treated. This drug shows the effect within a day and may take up to a week to get the better results.

Is it addictive?

No, it is not addictive. This drug does not have any characteristics to elicit any addictive or habit-forming responses.

What is the Dosage?

This drug is available in different dosages such as 2.5 mg, 5 mg and 10 mg and also it varies in its dosage according to the age, sex, weight, pre-medical history and the condition to be treated of the person.

In adults, the dosage for different medical conditions such as

• For Hypertension, the initial dosage is about 5 mg and it can be exceeded up to 10 mg per day.
• For Coronary artery disease, the dosage starts with 5 mg to 10 mg taken once a day.
• For Angina, the dosage to begin with lies between 5 mg and 10 mg.
• In case if you are predicted with the previous medical history of hepatic[12] disease, the initial dosage should be from 2.5 mg and should not exceed 5 mg.

What if I miss a dose?

Try not to miss a dose of this drug as it may delay curing the condition. Take the missed dose as soon as you remember it. If it is already time for your next dose, avoid the missed dose and continue with your regular dosage.

What to do in case of overdosage?

The overdosage of this drug may cause the patient to have trouble breathing or passing out. The other symptoms included are fainting and severe dizziness[13]. If you experience these symptoms then consult your doctor immediately for further advice.

What to do if there is an allergic reaction?

This drug may or may not cause allergic reactions[14]. It can be due to the presence of active ingredients. Some of the unusual and rarely observed allergic reactions are,

• Skin Rashes
• Itching skin
• Swelling (especially in face, tongue and throat)

If you have any of the above mentioned allergic reactions, seek the emergency help from your doctor as soon as possible.

Can I drive after taking it?

No, you cannot drive after taking this medicine. Some people (especially older people) experiences dizziness after taking this drug and it is not advisable to drive a vehicle or operate any heavy types of machinery.

Can it be taken with food?

No, it cannot be taken with food. The effect will be better if you consume the drug after food.

Can it be taken on an empty stomach?

No, it cannot be taken on an empty stomach. The positive effect will be shown if you take this after your meals.

Can it be taken with alcohol?

No, it cannot be taken with alcohol. This drug when it interacts with alcohol can cause or intensifies the severe dizziness.

What are the side effects?

This drug may cause both short term and long term side effects. Some of the well know and proved side effects are listed below,

• Swelling (edema) in the ankles and feet
• Dizziness or drowsiness
• Nausea[15] and vomiting
• Palpitations
• Troubled breathing
• Pulmonary edema (lungs filled with the fluid)
• Lightheadedness
• Pounding or irregular heartbeat (fast rhythm)
• Worsening chest pain
• Unusual sweating
• Pain in the Jaw or left arm
• Shortness of breath
• Muscle spasms and muscle cramps
• Tremors
• Weakening and rigidity of muscles
• Restlessness or tiredness
• Sleepiness

Does this medicine has any drug interactions?

There are some drugs whose active ingredients are involved in interactions with Amlodipine. These drug interactions may tend to increase blood pressure much more. On another hand, it would lower the potency of this drug to treat the high blood pressure. Such kind of drugs,

• Diet Aids
• Vitamin supplements
• Herbal drugs
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen or naproxen
• Antibiotics – clarithromycin, erythromycin, rifampicin
• Diltiazem and verapamil
• Antifungals like itraconazole or ketoconazole
• Drugs to treat HIV or Hepatitis
• Anti-epilepsy drugs (Carbamazepine, phenytoin, phenobarbital or primidone)
• Drugs to lower the cholesterol like Simvastatin
• Ciclosporin or tacrolimus (drugs to suppress the immune system)
• Dantrolene
• Idelalisib
• Ivacaftor
• Nefazodone

Precautions 

Here is the list of some precautions and warnings to be followed while taking this drug,

• Let your physician know if you are allergic to the active ingredients present in the drug.
• Avoid consuming alcohol and stop smoking in order to control the high blood pressure.
• Change your diet plan with low cholesterol containing food to avoid the accumulation of cholesterol in the arteries.
• Avoid both physical and mental stress as it worsens the conditions of heart disease.
• Monitor your blood pressure at regular interval time.
• Consult your doctor if your blood pressure is still elevated or if you experience the chest pain again.
• Tell your doctor if you have any previous medical history especially hepatic diseases, heart diseases (aortic stenosis) or very low blood pressure.
• Consult your doctor if your doctor if you are already taking any other drugs to avoid drug interactions.

Is this safe to use if I am pregnant?

The aftermath effect of this drug during the period of pregnancy is not known and it is still unclear. So, it is safe to consult your doctor before taking this drug.

Is this safe to use if I am breastfeeding?

This drug is observed to pass through the breast milk which can affect the infant’s health. Hence consult your doctor beforehand to avoid dangerous side effects.

Can this medicine be given to Children and Infants?

No, this medicine cannot be given to children and infants. It is not recommended for children under 6 years unless it is specifically prescribed by the doctor for a particular condition.

Is this medicine available as over the counter (OTC) product?

Yes, this medicine is available as Over the counter (OTC) product.

Frequently asked questions

How can you store this drug?

This drug should be stored in room temperature and should not be in cold temperature (at refrigerator or freezer) unless it is particularly mentioned in the package. Store this medicine away from direct light, heat or moisture (especially not in the bathroom). Always keep this drug away from children and pets as it can cause harmful effects to them. Discard the medicine properly when it is expired or no longer needed and do not discard the drug improperly by flushing it in sink or toilet.

What happens if I take an expired drug?

This drug when it reaches its expiration period loses its effectiveness to treat the conditions. But at sometimes it may cause the rebound effects by increasing the blood pressure and leads to heart attack or heart failure. Seek the medical emergency help as soon as possible if you experience the any one of the mentioned symptoms.

What is the effect of this drug on organs?

This drug can affect the liver as it is metabolized in the hepatic region. After metabolized in the liver, amlodipine begins its excretion in the kidney and sometimes, it may lead to the UTI (Urinary tract infection). Sometimes it may cause a defect in the functioning of the heart and the blood vessels.

What are the substitutes of this drug?

Below is the list of drugs which works similar to the amlodipine,

• Nifedipine
• Felodipine
• Lacidipine
• Lercanidipine
• Diltiazem
• Verapamil
• ACE inhibitors such as Rampiril and lisinopril
• Diuretics such as Bendroflumethiazide
• Beta blockers such as bisoprolol
• Angiotensin receptor blockers such as Candesartan

How to take this drug?

This drug is available in the form of tablets. It can be taken orally by mouth with or without food as per the advice of your physician. It should be taken only once in a day and try to take it at the same time every day. Swallow the tablet wholly with a glass of water and do not crush, chew or break it.

What is the price of this drug?

A pack of 10 tablets (5 mg) of this drug costs about Rs. 20.

What happens if this drug is abruptly stopped?

This drug cannot be abruptly stopped. This may lead to an increase in blood pressure or increase the chance of heart attack or chest pain. So, consult your doctor if you want to stop consuming this drug.

When to avoid this drug?

This drug is advisable to avoid this drug if you had experienced or treated for the following medical conditions,

• Hepatic diseases (Hepatitis)
• Renal disorder (Kidney failure)
• Pregnant or breastfeeding
• Planning to get pregnant
• Heart diseases (Heart attack)

Any specific food items to be avoided while taking this drug?

Yes, avoid taking grapefruit or grapefruit juices while taking this drug.

Is this drug is safe to take for a long time?

Yes, it is safe to take this medicine for a long time. In fact, this drug shows its best effect if you continue to consume this drug for a long period of time. But the duration of the medication has to be decided by the doctor.

What are the drugs used in combination with this drug?

The following drugs are used in combination with this medicine to treat the mentioned conditions:

• Along with Atorvastatin, it is used to prevent cardiovascular diseases and high cholesterol level.
• Aliskiren is a renin inhibitor, which is used to reduce hypertension.
• Hydrochlorothiazide is a diuretic which is involved in the reduction of overall blood volume.
• Benazepril is an ACE inhibitor and involves the blocking of Angiotensin I and Angiotensin II.
• Olmesartan being an inhibitor used as the angiotensin II receptor antagonist.
• Perindopril is also an ACE inhibitor and causes the blockage of Angiotensin receptor.
• Telmisartan is considered as an Antagonist of Angiotensin receptor.
• Valsartan along with hydrochlorothiazide is also an Angiotensin receptor antagonist.

What is the pharmacokinetics of this drug?

This drug is rapidly absorbed by the cells and tissues of the body. Binding of this drug to the protein is about 93%. This drug is metabolized in the liver and has the highest bioavailability of about 60 to 90% which happens between 6 to 12 hours.  hours. The period of half-life elimination is about 30 to 50Then this drug undergoes excretion by the kidney and excreted remnants of this medicine through urine within 24 hours.

Reference

Wikipedia page on Chest pain

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