Amlodipine

What is Amlodipine?

Amlodipine, also known as Istin, is a medication used to treat high blood pressure (hypertension). Amlodipine is a type of calcium-channel blocker. This means it blocks the calcium channels in your body, which helps to relax and widen the blood vessels. This widening of the blood vessels, means that blood can flow through them more easily, reducing your blood pressure. 

How does Amlodipine work?

Amlodipine treats high blood pressure and prevents heart attacks, heart disease and strokes from occurring in the future. As a calcium-channel blocker, Amlodipine interferes with calcium channel signalling, which can cause narrowing of your blood vessels. Instead, by blocking the calcium channels, it allows your blood vessels to relax, helping blood to flow freely around the body. Amlodipine is also used to treat angina. In this case it helps to get blood to the heart faster to provide enough oxygen.

How quickly does Amlodipine work?

Amlodipine will start to work from day one, although it may take a few weeks before it will make a real difference. High blood pressure often won’t cause symptoms so you may not feel any different. This doesn’t mean that you should stop taking your medicine. If you are taking it to treat angina, then you will usually notice an improvement in your symptoms after a number of weeks.

How can I tell if Amlodipine is working?

Having regular check ups with your doctor means they can measure your blood pressure to check how well the Amlodipine is working. Or if you are comfortable doing so, you can measure your own blood pressure at home with the appropriate equipment. 

Active ingredients

The active ingredient is amlodipine mesilate monohydrate. Each tablet contains either 5 or 10mg, depending on the overall dose of the tablet.

Inactive ingredients

The other ingredients in this medicine are microcrystalline cellulose, calcium hydrogen phosphate, sodium starch glycollate type A and magnesium stearate. 

Please Note: Inactive ingredients may vary between different brands of generic Amlodipine.

How to take Amlodipine

Amlodipine is usually taken once a day and you should always follow the instructions given by your doctor. You should take it at the same time each day and it doesn’t have to be taken with food. You should avoid consuming grapefruit or grapefruit juice while you are taking Amlodipine as the fruit can heighten the level of Amlodipine in the body, making you more likely to suffer from side effects.

Can Amlodipine tablets be crushed or split?

You can dissolve the tablets in a glass of water if you find that easier, provided you drink it right away. Always take the prescribed dose, either as a full tablet or by measuring it out if the Amlodipine is in liquid form.  

Amlodipine side effects

Not everyone will experience the side effects listed and some are more common than others. Common mild side effects include:

• Dizziness
• Headaches
• Swollen ankles
• Flushing
• Pounding heartbeat

More than 1 in 100 people will experience these side effects which usually subside after the first few weeks. Less common and serious side effects include: 

• Severe stomach pain, bloody diarrhea, feeling sick and vomiting are signs of pancreatitis
• Jaundiced skin (a yellowing of the skin or eyes) 
• Chest pain

Signs of an allergic reaction should be taken seriously and receive immediate medical attention. These are:

• A severe or itchy rash
• Wheezing or trouble breathing
• Tightness in the throat or chest
• Swelling in the face and neck    

Contraindications

Amlodipine is not suitable for children younger than six, pregnant women or women who are breastfeeding, people with a liver or kidney disease or if you have suffered from a heart attack recently or have heart failure. It should not be taken if you are allergic to either Amlodipine or have had a reaction to other medicines in the past.

Drug interactions

If you are already taking medications for high blood pressure, then the combination might cause your blood pressure to drop too low. There are other medications which interact with Amlodipine and stop it from working properly. You’ll need to inform your doctor if you are taking: 

• Antibiotics such as erythromycin, clarithromycin and rifampicin
• Itraconazole or ketoconazole (antifungal treatment)
• HIV or hepatitis C medication 
• Medicines to treat epilepsy 
• Immune suppressors 
• Simvastatin to lower the cholesterol (if your dose is higher than 20mg)
• St John’s Wort  

Amlodipine and alcohol

You can drink alcohol while taking Amlodipine but it can enhance the decrease of your blood pressure leaving you feeling sleepy, dizzy or developing headaches. If you get these side effects, you may want to consider cutting out alcohol for the duration of your treatment.

Amlodipine and pregnancy

Amlodipine is not safe to take during pregnancy as it can be harmful to a developing baby. Alert your doctor right away if you fall pregnant while you are taking this medicine. There are safer alternatives they can recommend. 

Can Amlodipine affect my contraception?

While Amlodipine won’t have an affect on your contraception, the combined pill can lower the effectiveness of Amlodipine as it can cause high blood pressure. If you have high blood pressure, it’s unlikely that you’ll be able to take the combined pill but if this is an issue for you then inform your doctor or pharmacist. 

Can you take Amlodipine with Paracetamol?

It’s fine to take Paracetamol with Amlodipine but you should always inform your doctor of any additional medicines you are taking, including over the counter or herbal remedies, in case they cause interference. 

Can Amlodipine be used for Raynaud's syndrome?

Raynaud’s syndrome, where the circulation is reduced to the fingers and toes when you get too cold, can be treated with Amlodipine. It helps to get your blood flowing more freely which can reduce the discomfort and boost your circulation. 

Could Amlodipine affect my fertility?

There is no evidence to suggest that Amlodipine will affect a woman’s fertility. It might be possible that Amlodipine could alter sperm temporarily to cause difficulties for men participating in IVF as a method of fertilisation. However, this link has yet to be proven. 

Will Amlodipine affect my sex life?

While some types of medications for high blood pressure can cause erectile dysfunction, it’s rare for Amlodipine to have this effect. 

How to cope with Amlodipine side effects

If you experience headaches, these shouldn’t last longer than a week. Drinking plenty of fluids, resting and taking painkillers can help to manage this. If you get dizzy after taking Amlodipine, either sit or lie down until the dizziness passes. Cutting down on alcohol, coffee and tea will help to ease facial flushing and raising your legs at a 90 degree angle can ease swollen ankles. 

Can I make lifestyle changes instead of taking Amlodipine?

Making healthy changes to your lifestyle will improve the health of your heart and have a positive effect on your blood pressure. Some things you can do include: 

• Staying active - you should aim for a minimum of 30 minutes of exercise per day
• Reduce your salt intake. Adults should be consuming a maximum of 6g of salt a day
• Reduce your intake of saturated fats
• Lose weight- if you are overweight this puts strain on your heart
• Eat plenty of fruit and vegetables

Always consult your doctor first. You may still need to take Amlodipine in order to manage your blood pressure.   

Amlodipine vs other calcium channel blockers

The different variety of calcium-channel blockers available work in different ways. Which medicine is best for you will depend on what condition you are being treated for, the severity of your symptoms and other factors such as age. For example Diltiazem and Verapamil treat different heart problems rather than hypertension and have their own side effects associated with them. 

Alternatives to Amlodipine

There are other medicines which work in the same way as Amlodipine. These calcium-channel blockers are:

• Nifedipine- which also comes in short action form and is commonly used to treat Raynaud’s phenomenon and chilblains 
• Felodipine- these tablets are taken in the morning and slowly release their effects throughout the day
• Lacidipine- which may not be suitable for more severe forms of angina
• Lercanidipine- this is best to take on an empty stomach and fatty food can interfere and make you more likely to have side effects  

Is Amlodipine a statin?

Amlodipine belongs to a group of medicines called calcium-channel blockers to lower the blood pressure whereas a statin is used to reduce cholesterol. 

What happens if I stop taking Amlodipine?

If you stop taking Amlodipine then your blood pressure is likely to rise again. You should continue to take it as prescribed even if your blood pressure has improved.

Can I drive when taking Amlodipine?

If Amlodipine makes you dizzy, then you shouldn’t drive until the dizziness wears off. This can be dangerous both for you and others on the road. 

Is Amlodipine a cure?

There is no cure for high blood pressure. Amlodipine is a long term treatment that, combined with a healthy lifestyle, manages your condition by keeping your blood pressure at the optimum level, reducing your risk of having heart problems as a result.   

How can you make Amlodipine work faster?

Making positive lifestyle changes may help Amlodipine to work faster . Exercising, eating a healthy diet and watching your salt intake are all important factors in maintaining a healthy heart.  

Will I need Amlodipine for the rest of my life?

It’s likely that you will need Amlodipine for the rest of your life as this is a long term treatment. However, by continuing to take your medication you are protecting yourself from having a heart attack or stroke in the future, or from developing heart disease. 

Can I stop taking Amlodipine if my blood pressure if lower?

You should continue to take Amlodipine even if your blood pressure is lower as this means the medication is working. If you stop taking it then your blood pressure is likely to return to its previous state. You need to keep taking Amlodipine to maintain a healthy level.  

How to store Amlodipine

You should store Amlodipine at room temperature, outside of the bathroom, in the packet it came in and ensure it’s kept out of reach of children and pets.

Is Amlodipine related to cancer risk?

A study by University Hospitals Case Medical Center and Case Western Reserve University School of Medicine in Cleveland, USA found that Amlodipine may be associated with an increased risk of developing cancer. However, the research concluded that the risk factor is relatively low and may need further investigation. Ask your doctor or pharmacist for advice if this is something that worries you. 

Are there withdrawal symptoms associated with Amlodipine?

You should consult your doctor before you stop taking Amlodipine where they will gradually decrease your dose. Otherwise, your blood pressure may spike and you could experience chest pain. 

Is Amlodipine addictive?

Amlodipine is not an addictive substance. 

Can I take Amlodipine for migraines?

Amlodipine can be used to treat migraines, although there’s not enough evidence to show that this treatment is effective enough. It’s likely to be prescribed if other migraine treatments have been ineffective or aren’t suitable for any reason.  

Can I take Amlodipine for anxiety?

While anxiety could cause a spike in your blood pressure, Amlodipine is not designed to treat anxiety. The medicine relaxes your blood vessels but does not treat your mental health. If you are experiencing issues with anxiety then seek help from your doctor who may prescribe you with treatment such as antidepressants or talking therapy.

Sources

• Patient Information Leaflet
• NICE > Calcium Channel Blockers
• NHS > Amlodipine
• NHS > Blood Pressure Pills 'Cancer Link'
• NHS > Lercanidipine
• NHS > Felodipine
• NHS > Nifedipine
• Mayo Clinic > Amlodipine
• Migraine > Calcium Channel Blockers
• WebMD > Blood Pressure Medication and ED
• Versus Arthritis > Raynaud's Phenomenon