Amlodipine

What Does Amlodipine Do?

Amlodipine is primarily used to treat high blood pressure and angina. As a calcium channel blocker, it relaxes the blood vessels, allowing the heart to pump blood more efficiently and reducing its workload.

How Does Amlodipine Work?

In simple terms, Amlodipine works by blocking calcium from entering the muscle cells of the heart and blood vessels. This helps to relax the blood vessels, making it easier for blood to flow and reducing the effort the heart needs to pump. As a result, it lowers blood pressure and reduces chest pain (angina) by decreasing the heart's workload and oxygen demand. 

Let’s look at it more technically: 

Amlodipine functions by inhibiting the entry of calcium ions into vascular smooth muscle and cardiac muscle cells during membrane depolarisation. This action decreases vascular resistance and oxygen demand, which in turn lowers blood pressure. By blocking calcium ion influx, amlodipine relaxes vascular smooth muscle and reduces peripheral vascular resistance. This results in a lower afterload and decreased myocardial oxygen demand, helping to reduce blood pressure and alleviate angina symptoms by making it easier for the heart to pump blood and reducing its workload.

Drug Type and Category of Amlodipine

Amlodipine is a medication classified as a calcium channel blocker. Specifically, it belongs to the dihydropyridine class of calcium channel blockers. This category of drugs is commonly used to treat hypertension (high blood pressure) and angina (chest pain).

What dosage of Amlodipine should you be taking?

The appropriate dosage of amlodipine varies from person to person. It's important to consult a healthcare professional who can determine the right dosage based on your health condition.

NICE Guidelines for Amlodipine ¹ 

According to NICE (National Institute for Health and Care Excellence) guidelines:

• Calcium channel blockers like amlodipine are recommended as first-line treatment for hypertension in adults aged 55 or over who do not have type 2 diabetes, and in adults of any age with Black African or African-Caribbean family origin who do not have type 2 diabetes.
• For stable angina, calcium channel blockers are recommended as first-line treatment
• The target blood pressure for most patients is <140>
• For patients with diabetes, a diastolic blood pressure target of <85>

NICE does not make a specific recommendation on which calcium channel blocker to choose, as amlodipine and modified-release felodipine are considered equally effective. Choosing between amlodipine and modified-release felodipine should be based on licensed indications, individual patient factors, potential interactions, side effects, and cost.

What are the side-effects of Amlodipine?

Amlodipine is generally well-tolerated- however, there have been some reports of side-effects.

Common side effects of amlodipine include:

• Swelling of the ankles or feet (edema)
• Dizziness or lightheadedness
• Flushing (warmth, redness, or tingly feeling)
• Fatigue or tiredness
• Nausea
• Abdominal pain

Less common side effects can include:

• Palpitations (irregular heartbeats)
• Muscle cramps
• Shortness of breath
• Severe allergic reactions (rash, itching, swelling, severe dizziness, trouble breathing)
• Chest pain or angina worsening

Rare but serious side effects:

• Severe hypotension (very low blood pressure)
• Hepatitis (liver inflammation)
• Jaundice (yellowing of the skin or eyes)

Drug Interactions

Amlodipine is known to interact with a number of other medications. Concurrent use of CYP3A4 inhibitors, like ketoconazole, ritonavir, or erythromycin, could lead to increased plasma concentrations of amlodipine, requiring the dosage adjustment. Amlodipine can also potentiate the effects of other antihypertensive drugs, such as diuretics and beta-blockers. Additionally, administering amlodipine with grapefruit juice can enhance its bioavailability, hence it's recommended to avoid such a combination.

Natural Alternatives to Amlodipine

Some natural alternatives that may help lower blood pressure ³, similar to the effect of amlodipine:

• Omega-3 fatty acids from fish oil can help relax blood vessels and lower blood pressure.
• Garlic may have mild blood pressure-lowering effects. 
• Bergamot contains polyphenols that may help lower blood pressure.
• Berberine is a herbal compound that can help dilate blood vessels.
• Green tea contains antioxidants that may provide cardiovascular benefits.

While these natural alternatives have shown potential benefits, they should not be considered substitutes for medical treatment. It is essential for individuals to consult their healthcare providers before using these supplements to ensure they are safe and appropriate for their specific health needs.

Key Factors for Natural Resolution:

• Step 1: Lose weight.
• Step 2: Exercise.
• Step 3: Improve your diet.
• Step 4: Quit smoking. 

Interesting facts about Amlodipine

Amlodipine is known for its convenience, often taken once daily due to its long-lasting effects. Amlodipine is considered safe for children and adolescents under medical supervision and is recognised globally as an essential medicine by the World Health Organization. Ongoing research explores potential new uses, reflecting its importance in cardiovascular care.

In 2024, amlodipine was the second most commonly prescribed drug in the UK. 

Disclaimer:

This article is generated for informational purposes only. It was created in June 2024. Medications and medical guidance can change over time. Therefore, it is essential to consult with your general practitioner or healthcare provider before making any decisions regarding medications or treatment plans. Your GP can provide personalised advice based on your specific health needs and conditions.

References

1. https://www.nice.org.uk/bnf-uk-only
2. https://www.stlukes-stl.com/health-content/medicine/33/000087.htm
3. https://www.cardiosmart.org/news/2018/7/natural-alternatives-to-cholesterol-lowering-statins