General Articles

Amlodipine

MEDICATION SAFETY ISSUES
Sound-alike/look-alike issues:
AmLODIPine may be confused with aMILoride
Norvasc® may be confused with Navane®, Norvir®, Vascor®

U.S. BRAND NAMES — Norvasc®

PHARMACOLOGIC CATEGORY
Calcium Channel Blocker
Calcium Channel Blocker, Dihydropyridine

DOSING: ADULTS
Hypertension: Oral: Initial dose: 5 mg once daily; maximum dose: 10 mg once daily. In general, titrate in 2.5 mg increments over 7-14 days. Usual dosage range (JNC 7): 2.5-10 mg once daily.

Angina: Oral: Usual dose: 5-10 mg; lower dose suggested in elderly or hepatic impairment; most patients require 10 mg for adequate effect.

DOSING: PEDIATRIC — Hypertension: Oral: Children 6-17 years: 2.5-5 mg once daily

(For additional information see “Amlodipine: Pediatric drug information”)

DOSING: ELDERLY — Dosing should start at the lower end of dosing range due to possible increased incidence of hepatic, renal, or cardiac impairment. Elderly patients also show decreased clearance of amlodipine.

Hypertension: Oral: 2.5 mg once daily

Angina: Oral: 5 mg once daily

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DOSING: RENAL IMPAIRMENT — Dialysis: Hemodialysis and peritoneal dialysis do not enhance elimination. Supplemental dose is not necessary.

DOSING: HEPATIC IMPAIRMENT
Hypertension: Administer 2.5 mg once daily

Angina: Administer 5 mg once daily

DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet: 2.5 mg, 5 mg, 10 mg
Norvasc®: 2.5 mg, 5 mg, 10 mg

DOSAGE FORMS: CONCISE
Tablet: 2.5 mg, 5 mg, 10 mg
Norvasc®: 2.5 mg, 5 mg, 10 mg

GENERIC EQUIVALENT AVAILABLE — Yes

ADMINISTRATION — May be administered without regard to meals.

USE — Treatment of hypertension; treatment of symptomatic chronic stable angina, vasospastic (Prinzmetal’s) angina (confirmed or suspected); prevention of hospitalization due to angina with documented CAD (limited to patients without heart failure or ejection fraction <40%)>10%: Cardiovascular: Peripheral edema (2% to 15% dose related)

1% to 10%:
Cardiovascular: Flushing (1% to 3%), palpitation (1% to 4%)
Central nervous system: Headache (7%; similar to placebo 8%), dizziness (1% to 3%), fatigue (4%), somnolence (1% to 2%)
Dermatologic: Rash (1% to 2%), pruritus (1% to 2%)
Endocrine & metabolic: Male sexual dysfunction (1% to 2%)
Gastrointestinal: Nausea (3%), abdominal pain (1% to 2%), dyspepsia (1% to 2%), gingival hyperplasia
Neuromuscular & skeletal: Muscle cramps (1% to 2%), weakness (1% to 2%)
Respiratory: Dyspnea (1% to 2%), pulmonary edema (15% from PRAISE trial, CHF population)

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<1%>90%) to inactive metabolite

Bioavailability: 64% to 90%

Half-life elimination: 30-50 hours; increased with hepatic dysfunction

Time to peak, plasma: 6-12 hours

Excretion: Urine (10% as parent, 60% as metabolite)

PATIENT INFORMATION — Take as prescribed; do not stop abruptly without consulting prescriber. You may experience headache (if unrelieved, consult prescriber), nausea or vomiting (frequent small meals may help), or constipation (increased dietary bulk and fluids may help). May cause drowsiness; use caution when driving or engaging in tasks that require alertness until response to drug is known. Report unrelieved headache, vomiting, constipation, palpitations, peripheral or facial swelling, weight gain >5 lb/week, or respiratory changes.


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