U.S. flag

An official website of the United States government

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

Cover of StatPearls

StatPearls [Internet].

Show details


; ; .

Author Information and Affiliations

Last Update: April 21, 2024.

Continuing Education Activity

Amlodipine, an oral dihydropyridine calcium channel blocker, demonstrates prolonged efficacy by inhibiting voltage-dependent L-type calcium channels. This action interrupts initial calcium influx, distinguishing it within its pharmacological class. With a half-life of 30 to 50 hours, amlodipine affords the convenience of once-daily dosing, contrasting with shorter-acting alternatives like nifedipine. Approved as amlodipine besylate by the FDA in 1987, this medication has since become a cornerstone in managing hypertension and related conditions. This activity discusses the indications, contraindications, and nuances of amlodipine therapy essential for interprofessional collaboration. By also discussing off-label uses, monitoring protocols, and pharmacokinetic intricacies, healthcare professionals can tailor treatment regimens to individual patient needs. Armed with a comprehensive understanding of amlodipine's pharmacology, healthcare providers are empowered to optimize therapeutic outcomes while mitigating adverse effects, thereby enhancing patient care and safety.


  • Identify the FDA-approved and off-label indications of amlodipine.
  • Evaluate the mechanism of action of amlodipine.
  • Assess the adverse drug reactions of amlodipine.
  • Implement effective collaboration and communication among interprofessional team members to improve outcomes and treatment efficacy for patients who might benefit from amlodipine pharmacotherapy.
Access free multiple choice questions on this topic.


Amlodipine is an oral dihydropyridine calcium channel blocker. The FDA initially approved amlodipine besylate in 1987.

FDA-Approved Indications

  • Hypertension: Amlodipine is an excellent first-line choice among the multiple options of antihypertensive agents. It may be used alone or in combination with other antihypertensive agents.[1][2]
  • Chronic stable angina: Amlodipine is indicated for the symptomatic treatment of chronic stable angina. Amlodipine may be used alone or in combination with other antianginal agents.[3]  
  • Vasospastic angina (Prinzmetal or variant angina): Amlodipine is indicated to treat confirmed or suspected vasospastic angina.[4] 
  • Angiographically documented coronary artery disease (CAD): In patients with recently documented CAD by angiography and without heart failure or an ejection fraction <40%, amlodipine is indicated to reduce the risk of hospitalization from angina and reduce the risk of a coronary revascularization procedure.[5]

Off-Label Uses

  • Diabetic nephropathy [6]
  • Left ventricular hypertrophy [7]
  • Raynaud phenomenon [8]
  • Silent myocardial ischemia [9][10]
  • Group 1 pulmonary arterial hypertension (PAH): Use only in patients with idiopathic PAH and positive vasodilator testing.[11]
  • Microvascular angina: According to the 2023 AHA/ACC guideline for chronic coronary disease, amlodipine should be considered as a third-line therapy for microvascular angina (non-obstructive coronary artery disease and proven coronary microvascular dysfunction) in patients already on β-blockers.[12] 
  • Kidney transplant recipients: According to the Kidney Disease: Improving Global Outcomes (KDIGO) Management of Blood Pressure in Chronic Kidney Disease guidelines, a dihydropyridine calcium channel blocker such as amlodipine or an angiotensin receptor blocker is recommended as the first-line antihypertensive agent in adult kidney transplant recipients.[13]

Mechanism of Action

Normally, vascular smooth muscle contraction begins when calcium enters the cell via voltage-dependent L-type calcium channels. The calcium binds to intracellular calmodulin, which binds to and activates myosin light-chain kinase (MLCK). MLCK is responsible for the phosphorylation of the myosin light chain, ultimately leading to muscle contraction and vasoconstriction. Calcium-induced calcium release from the sarcoplasmic reticulum further amplifies the vascular smooth muscle contraction. This sequence of events leads to a decreased vascular cross-sectional area, increased vascular resistance, and increased blood pressure.

Amlodipine blocks the voltage-dependent L-type calcium channels, inhibiting the initial calcium influx. Reduced intracellular calcium causes decreased vascular smooth muscle contractility, increased smooth muscle relaxation, and resultant vasodilation. Additionally, amlodipine is associated with improved vascular endothelial function in patients with hypertension. Amlodipine reduces blood pressure by inducing smooth muscle relaxation and vasodilatation.[3]

Amlodipine's role in relieving stable angina involves the reduction of afterload secondary to its vasodilatory and antihypertensive properties. Reducing afterload lowers myocardial oxygen demand at any level of exertion, as the heart does not need to work as hard to pump blood into the systemic circulation. Amlodipine also alleviates Prinzmetal or variant angina by blocking coronary spasms and restoring blood flow in the coronary arteries.[14]

Raynaud phenomenon (RP) is an excessive vascular response to cold temperature that manifests clinically by color changes of the distal skin of the digits and toes, nose, and earlobes. Amlodipine induces smooth muscle relaxation and is an effective short-term treatment for patients with Raynaud phenomenon.[15]

ACE inhibitors (ACE-Is)/angiotensin receptor blockers (ARBs) are the initial treatment of choice for diabetic nephropathy. However, clinical trials have shown that combined antihypertensive therapy with either amlodipine plus an ARBs/ACE-Is exerts a greater antiproteinuric effect in patients with type 2 diabetic nephropathy.[16][17]

ASCOT (Anglo-Scandinavian Outcome Trial) demonstrated that an amlodipine-based blood pressure regimen decreased the long-term incidence of stroke compared with atenolol, but further research is still required.[18]


Absorption: The absolute bioavailability of amlodipine is between 64% and 90%. Food does not alter the bioavailability of amlodipine. Peak plasma concentrations are achieved between 6 and 12 hours. Steady-state plasma levels are achieved after 7 to 8 days of daily dosing of amlodipine. Patients with hepatic dysfunction have decreased clearance of amlodipine. Accordingly, there is an increase in AUC of approximately 40% to 60% in patients with liver conditions.

Distribution: Amlodipine has high plasma protein binding (93%).

Metabolism: Amlodipine is extensively metabolized by the liver to inactive metabolites. CYP3A4 and CYP3A5 play an important role in the metabolism of amlodipine.[19][20][21]

Excretion: Amlodipine's plasma half-life is biphasic, with a terminal elimination half-life of about 30 to 50 hours, which is increased with hepatic dysfunction. Amlodipine is primarily excreted renally; 10% of the parent compound and 60% of the metabolites are excreted in the urine.


Available Dosage Forms and Strengths

Amlodipine is primarily administered orally and is available in 2.5, 5, and 10 mg tablets. Additionally, suspensions created from oral tablets are available for pediatric and older patients with difficulty swallowing. Compared to nifedipine and other medications in the dihydropyridine class, amlodipine has the longest half-life at 30 to 50 hours. The benefit of such a long half-life is having once-daily dosing.[22]

Recommended Dosages


  • Adults: Initial dose of 5 mg; maximum dose of 10 mg daily
  • Older and debilitated patients: Reduce initial dose to 2.5 mg; maximum dose of 10 mg daily
  • Adolescents and children aged 6 years or older: 2.5 to 5 mg once daily; maximum dose of 5 mg daily
  • Children aged 6 years old or younger: 0.05 to 0.2 mg/kg/d; maximum dose 0.3 to 0.6 mg/kg/d (up to 5 mg/d) [23]

CAD, Chronic Stable Angina, Prinzmental Angina, CAD Documented by Angiography and Without Heart Failure or Ejection Fraction Less than 40%

  • Adults: Initial dose 5 to 10 mg once daily
  • Older and debilitated patients: The initial dose is 5 mg once daily; the maintenance dose is 10 mg once daily.[4]

Amlodipine can be used as monotherapy or in combination with several different medications to manage hypertension or CAD. Common combinations include:

  • Amlodipine/atorvastatin: Atorvastatin is a lipid-lowering agent that blocks cholesterol synthesis and is administered to reduce cardiovascular events.[24][25]
  • Amlodipine/aliskiren or amlodipine/aliskiren/hydrochlorothiazide: Aliskiren is a direct renin inhibitor that binds renin and prevents activating the renin-angiotensin-aldosterone system (RAAS). Hydrochlorothiazide is a thiazide diuretic that leads to a reduction in blood volume. Both combinations lower blood pressure.[26][27]
  • Amlodipine/benazepril or amlodipine/perindopril: Benazepril and perindopril are ACE inhibitors that block the conversion of angiotensin I to angiotensin II in the RAAS.[28]
  • Amlodipine/olmesartan or amlodipine/telmisartan or amlodipine/valsartan: Olmesartan, telmisartan, and valsartan are angiotensin II receptor blockers (ARBs) that inhibit the activity of angiotensin II in the RAAS.[29][30]
  • Amlodipine/valsartan/hydrochlorothiazide: A randomized controlled trial demonstrated the efficacy of triple therapy (amlodipine/valsartan/hydrochlorothiazide) for moderate or severe hypertension.[31][32]

Specific Patient Population

Hepatic impairment: Amlodipine is primarily metabolized by the liver, and the plasma elimination half-life is prolonged with impaired hepatic function; gradual titration of the dose is recommended. The initial dose is 2.5 mg once daily for hypertension or 5 mg once daily for angina. Adjust the dosage based on clinical response.[2]

Renal impairment: Renal impairment does not significantly influence the pharmacokinetics of amlodipine. Consequently, patients with renal impairment do not require dose adjustment.

Pregnancy considerations: Untreated hypertension in pregnancy increases the risk of preeclampsia, premature delivery, intrauterine growth restriction (IUGR), and intrauterine death. Chronic Hypertension and Pregnancy (CHAP) results indicate that in pregnant women with mild chronic hypertension, an approach of target blood pressure of less than 140/90 mm Hg was associated with better pregnancy outcomes than a strategy of reserving treatment only for severe hypertension.[33] Based on these findings, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) guidelines suggest treatment with antihypertensive agents for mild chronic hypertension in pregnancy to a goal BP of <140/90 mm Hg.[34] Calcium channel blockers are widely used in pregnancy, and ACOG suggests other agents such as labetalol, nifedipine, and methyldopa.[35] However, amlodipine exposure in pregnancy does not appear to be associated with increased fetal malformations compared with other antihypertensive medications or maternal hypertension without treatment.[36] Based on a recent meta-analysis, amlodipine can also be used safely for hypertension during pregnancy.[37]

Breastfeeding considerations: Human milk levels of amlodipine are low, and plasma levels in breastfed infants are undetectable. Maternal use of amlodipine during breastfeeding has not caused any adverse effects in breastfed infants. Amlodipine is acceptable in nursing mothers.[36][38]

Pediatric patients: The efficacy and safety of amlodipine in children younger than 6 years old remain uncertain. Per the guidelines from the American Heart Association and American Thoracic Society for pediatric pulmonary hypertension, amlodipine doses should always be titrated up from a lower dose. A trial of amlodipine should be performed only in those patients who have positive acute vasoreactivity testing with nitric oxide or epoprostenol. In children with a previous history of high-altitude pulmonary edema (HAPE), amlodipine may be deemed a reasonable option for prophylaxis.[39]

Older patients: When prescribing amlodipine for older individuals, it's advisable to exercise caution, typically initiating treatment at the lower end of the dosage spectrum. This approach acknowledges the higher likelihood of impaired hepatic or cardiac function, as well as the increased incidence of accompanying diseases or concurrent medication usage. Older patients may have decreased clearance, leading to increased AUC, necessitating a lower initial dose.[2]

Adverse Effects

The significant adverse effects of amlodipine include peripheral edema, heart failure, pulmonary edema, flushing, dizziness, headache, drowsiness, skin rash, nausea, abdominal pain, and constipation. Researchers observed edema, dizziness, flushing, and palpitations in controlled clinical trials in a dose-dependent manner. For example, at a dose of 10 mg, the incidence of edema, dizziness, flushing, and palpitations was 10.8%, 3.4%, 2.6%, and 4.5%, respectively. The incidence of headaches, fatigue, nausea, and abdominal pain was 7.3%, 4.5%, 2.9%, and 1.6%, respectively.[40] 

Calcium channel blockers, including amlodipine, have been linked to rare instances of idiosyncratic drug-induced liver disease. A mixed hepatocellular-cholestatic pattern is typical of amlodipine-induced liver injury.[41] Patients have complete recovery 4 to 8 weeks after stopping the drug.[42] Amlodipine-induced gingival hyperplasia is a common adverse effect. Maintaining good oral hygiene practices is beneficial for prevention. In cases where gingival hyperplasia persists despite these measures, surgical intervention may be necessary.[43]

Drug-Drug Interactions

Coadministration of amlodipine and clarithromycin or erythromycin has reportedly increased the risk of hypotension and acute kidney injury due to decreased metabolism by CYP3A4.[44] Additionally, when amlodipine is used with high doses of statins, there is an increased risk for myopathy and rhabdomyolysis.[45] The interaction with tacrolimus is described in the monitoring section.

Prescribing Cascade

It is important to note that amlodipine can cause peripheral edema. A prescribing cascade occurs when the edema is mistaken as a new medical condition, and a diuretic is consequently prescribed to treat the edema.[46]


Amlodipine is contraindicated in patients with known hypersensitivity to amlodipine or its dosage form components. Lymphocyte transformation test (LTT) can be used to diagnose drug allergy.[47]

Warning and Precautions

Amlodipine is contraindicated in patients with cardiogenic shock, severe aortic stenosis, unstable angina, severe hypotension, heart failure, and hepatic impairment. According to the manufacturer's labeling, patients with severe coronary artery disease may have worsening angina after initiating amlodipine therapy. In cardiogenic shock, the heart cannot pump effectively, exacerbated by inhibiting the influx of calcium ions into cardiac cells. In severe aortic stenosis, amlodipine can cause ventricular collapse and dysfunction. Amlodipine causes a reflexive increase in cardiac contractility in unstable angina, increasing myocardial oxygen demand and worsening ischemia. Amlodipine can further reduce blood pressure, causing hypoperfusion to vital organs and syncope in patients with severe hypotension.[48] Patients with heart failure may experience pulmonary edema, shortness of breath, and dyspnea with amlodipine.[49] Patients with hepatic impairment may not metabolize amlodipine effectively, leading to a longer half-life with possible increases in plasma concentrations.[50]


In general, laboratory monitoring is not necessary for patients taking amlodipine. Since amlodipine is an antihypertensive medication, clinicians and patients should regularly measure blood pressure to achieve target levels per the 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines. Furthermore, the healthcare team should monitor patients for adverse effects such as peripheral edema, dizziness, and flushing.[51]

Amlodipine may increase the AUC of tacrolimus. In one study, amlodipine decreased the tacrolimus clearance by 2.2 to 3.8 fold, increasing AUC and systemic exposure in CYP3A5 expressers. Monitoring of trough blood levels of tacrolimus is recommended.[52]


Signs and Symptoms of Overdose

Amlodipine overdose and toxicity can lead to massive vasodilation, hypotension, and reflex tachycardia as compensatory mechanisms. Prolonged systemic hypotension can progress to shock and even death.

Management of Overdose

Activated charcoal (AC) should be administered to patients with amlodipine overdose. The hypotension usually remits intravenous (IV) fluid resuscitation, IV calcium gluconate, and vasopressor therapy with norepinephrine or dopamine. High-dose insulin is also sometimes administered as research has shown it lowers mortality and improves hemodynamics. Electrocardiographic results, vital signs, kidney function, urine output, and electrolytes require continual monitoring during an overdose.[48][53] As amlodipine has high plasma protein binding, hemodialysis is not likely to be beneficial. A recent case report describes successful resin hemadsorption/hemoperfusion treatment for amlodipine overdose, demonstrating its efficacy in resolving severe toxicity and hemodynamic instability.[54]

Enhancing Healthcare Team Outcomes

Amlodipine is a first-line choice among the myriad options of antihypertensive agents. Amlodipine has also shown robust reductions in cardiovascular endpoints (especially stroke). In addition, compared to nifedipine and other medications in the dihydropyridine class, amlodipine has the longest half-life at 30 to 50 hours. The benefit of such a long half-life is having once-daily dosing. Therefore, healthcare providers, including physicians, nurse practitioners, physician assistants, and pharmacists, should be familiar with the indications and contraindications of amlodipine. However, the drug can cause severe hypotension in overdose; it is recommended to titrate the dose with an initial low dose gradually. In addition, long-term patient monitoring is necessary for optimal blood pressure control. The PERSONAL-CovidBP trial demonstrated that smartphone-enabled remote precision dosing of amlodipine effectively lowered blood pressure in individuals with primary hypertension during the COVID-19 pandemic.[55]

Amlodipine therapy requires the participation of the entire interprofessional healthcare team. Clinicians (MDs, DOs, NPs, PAs) and specialists will typically initiate treatment. The pharmacist should report to the clinician for potential drug interactions (eg, simvastatin or erythromycin). In addition, pharmacists should verify dosing and educate the patient about the common adverse drug reactions. The nurse should assess patient adherence and offer to counsel on medication administration. Both nursing and pharmacy staff should alert the prescriber if they encounter any issues. In an acute overdose of amlodipine, emergency physicians and triage nurses should stabilize the patient with a primary focus on circulation. In a massive overdose of amlodipine, it is important to obtain an emergency consultation with a medical toxicologist. Critical care physician supervision is necessary for patients requiring vasopressor therapy in MICU.

The interprofessional team approach can improve patient outcomes related to amlodipine therapy by maximizing efficacy and minimizing the risk of adverse drug reactions. In addition, a pragmatic randomized controlled trial indicated that team-based care (TBC) involving community pharmacists and nurses working in an interprofessional manner with clinicians could accomplish long-term blood pressure control related to antihypertensive therapy, including calcium channel blockers.[56]

Review Questions


McCormack T, Krause T, O'Flynn N. Management of hypertension in adults in primary care: NICE guideline. Br J Gen Pract. 2012 Mar;62(596):163-4. [PMC free article: PMC3289819] [PubMed: 22429432]
Fares H, DiNicolantonio JJ, O'Keefe JH, Lavie CJ. Amlodipine in hypertension: a first-line agent with efficacy for improving blood pressure and patient outcomes. Open Heart. 2016;3(2):e000473. [PMC free article: PMC5051471] [PubMed: 27752334]
Ferrari R, Pavasini R, Camici PG, Crea F, Danchin N, Pinto F, Manolis A, Marzilli M, Rosano GMC, Lopez-Sendon J, Fox K. Anti-anginal drugs-beliefs and evidence: systematic review covering 50 years of medical treatment. Eur Heart J. 2019 Jan 07;40(2):190-194. [PubMed: 30165445]
Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RY, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV, Anderson JL., American College of Cardiology Foundation/American Heart Association Task Force. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012 Dec 18;126(25):e354-471. [PubMed: 23166211]
Pitt B, Byington RP, Furberg CD, Hunninghake DB, Mancini GB, Miller ME, Riley W. Effect of amlodipine on the progression of atherosclerosis and the occurrence of clinical events. PREVENT Investigators. Circulation. 2000 Sep 26;102(13):1503-10. [PubMed: 11004140]
Tabur S, Oğuz E, Sabuncu T, Korkmaz H, Çelik H. The effects of calcium channel blockers on nephropathy and pigment epithelium-derived factor in the treatment of hypertensive patients with type 2 diabetes mellitus. Clin Exp Hypertens. 2015;37(3):177-83. [PubMed: 25050869]
Ostroumova OD, Kochetkov AI. [Effects of Amlodipine/Lisinopril Fixed-Dose Combination on Severity of Left Ventricular Hypertrophy and Parameters of Myocardial Stiffness in Patients With Hypertension]. Kardiologiia. 2016 Dec;56(11):27-37. [PubMed: 28290816]
Lee EY, Park JK, Lee W, Kim YK, Park CS, Giles JT, Park JW, Shin K, Lee JS, Song YW, Lee EB. Head-to-head comparison of udenafil vs amlodipine in the treatment of secondary Raynaud's phenomenon: a double-blind, randomized, cross-over study. Rheumatology (Oxford). 2014 Apr;53(4):658-64. [PubMed: 24352340]
Perna GP, Valle G, Cianfrone N, Luca GD, Amico C, Coli C. Amlodipine in ischaemic left ventricular dysfunction with mild to moderate heart failure. Clin Drug Investig. 1998;16(4):289-96. [PubMed: 18370550]
Leonard L, Phillips WJ. Near-complete migraine prophylaxis with amlodipine: a case report. J Pain Symptom Manage. 2007 Dec;34(6):571-3. [PubMed: 18053876]
Velayati A, Valerio MG, Shen M, Tariq S, Lanier GM, Aronow WS. Update on pulmonary arterial hypertension pharmacotherapy. Postgrad Med. 2016 Jun;128(5):460-73. [PubMed: 27232660]
Writing Committee Members. Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, Dixon DL, Fearon WF, Hess B, Johnson HM, Kazi DS, Kolte D, Kumbhani DJ, LoFaso J, Mahtta D, Mark DB, Minissian M, Navar AM, Patel AR, Piano MR, Rodriguez F, Talbot AW, Taqueti VR, Thomas RJ, van Diepen S, Wiggins B, Williams MS. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023 Aug 29;82(9):833-955. [PubMed: 37480922]
Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. 2021 Mar;99(3S):S1-S87. [PubMed: 33637192]
Tang L, Gamal El-Din TM, Swanson TM, Pryde DC, Scheuer T, Zheng N, Catterall WA. Structural basis for inhibition of a voltage-gated Ca2+ channel by Ca2+ antagonist drugs. Nature. 2016 Sep 01;537(7618):117-121. [PMC free article: PMC5161592] [PubMed: 27556947]
Pope J. Raynaud's phenomenon (primary). BMJ Clin Evid. 2013 Oct 10;2013:1119. [PMC free article: PMC3794700] [PubMed: 24112969]
Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, Ritz E, Atkins RC, Rohde R, Raz I., Collaborative Study Group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001 Sep 20;345(12):851-60. [PubMed: 11565517]
Kuriyama S, Tomonari H, Tokudome G, Horiguchi M, Hayashi H, Kobayashi H, Ishikawa M, Hosoya T. Antiproteinuric effects of combined antihypertensive therapies in patients with overt type 2 diabetic nephropathy. Hypertens Res. 2002 Nov;25(6):849-55. [PubMed: 12484508]
Whiteley WN, Gupta AK, Godec T, Rostamian S, Whitehouse A, Mackay J, Sever PS. Long-Term Incidence of Stroke and Dementia in ASCOT. Stroke. 2021 Oct;52(10):3088-3096. [PMC free article: PMC8478091] [PubMed: 34192893]
Zhu Y, Wang F, Li Q, Zhu M, Du A, Tang W, Chen W. Amlodipine metabolism in human liver microsomes and roles of CYP3A4/5 in the dihydropyridine dehydrogenation. Drug Metab Dispos. 2014 Feb;42(2):245-9. [PubMed: 24301608]
Cataldi M, Celentano C, Bencivenga L, Arcopinto M, Resnati C, Manes A, Dodani L, Comnes L, Vander Stichele R, Kalra D, Rengo G, Giallauria F, Trama U, Ferrara N, Cittadini A, Taglialatela M. Identification of Drugs Acting as Perpetrators in Common Drug Interactions in a Cohort of Geriatric Patients from Southern Italy and Analysis of the Gene Polymorphisms That Affect Their Interacting Potential. Geriatrics (Basel). 2023 Aug 24;8(5) [PMC free article: PMC10514861] [PubMed: 37736884]
Liang H, Zhang X, Ma Z, Sun Y, Shu C, Zhu Y, Zhang Y, Hu S, Fu X, Liu L. Association of CYP3A5 Gene Polymorphisms and Amlodipine-Induced Peripheral Edema in Chinese Han Patients with Essential Hypertension. Pharmgenomics Pers Med. 2021;14:189-197. [PMC free article: PMC7866951] [PubMed: 33564260]
van Zwieten PA. Amlodipine: an overview of its pharmacodynamic and pharmacokinetic properties. Clin Cardiol. 1994 Sep;17(9 Suppl 3):III3-6. [PubMed: 9156957]
Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, Ramirez A, Schlaich M, Stergiou GS, Tomaszewski M, Wainford RD, Williams B, Schutte AE. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020 Jun;75(6):1334-1357. [PubMed: 32370572]
Athyros VG, Katsiki N, Karagiannis A. Cardiovascular risk reduction with combination of anti-atherosclerotic medications in younger and older patients. Curr Med Res Opin. 2013 Jul;29(7):791-2. [PubMed: 23672630]
Curran MP. Amlodipine/Atorvastatin: a review of its use in the treatment of hypertension and dyslipidaemia and the prevention of cardiovascular disease. Drugs. 2010;70(2):191-213. [PubMed: 20108992]
Teo KK, Pfeffer M, Mancia G, O'Donnell M, Dagenais G, Diaz R, Dans A, Liu L, Bosch J, Joseph P, Copland I, Jung H, Pogue J, Yusuf S., Aliskiren Prevention of Later Life Outcomes trial Investigators. Aliskiren alone or with other antihypertensives in the elderly with borderline and stage 1 hypertension: the APOLLO trial. Eur Heart J. 2014 Jul;35(26):1743-51. [PMC free article: PMC5994823] [PubMed: 24616335]
Zion AS, Izzo JL. Combination therapy with aliskiren and amlodipine in hypertension: treatment rationale and clinical results. Expert Rev Cardiovasc Ther. 2011 Apr;9(4):421-7. [PubMed: 21417713]
Brook RD, Kaciroti N, Bakris G, Dahlöf B, Pitt B, Velazquez E, Weber M, Zappe DH, Hau T, Jamerson KA. Prior Medications and the Cardiovascular Benefits From Combination Angiotensin-Converting Enzyme Inhibition Plus Calcium Channel Blockade Among High-Risk Hypertensive Patients. J Am Heart Assoc. 2018 Jan 04;7(1) [PMC free article: PMC5778960] [PubMed: 29301757]
Ruilope LM., SEVITENSION Study Investigators. Fixed-Combination Olmesartan/Amlodipine Was Superior to Perindopril + Amlodipine in Reducing Central Systolic Blood Pressure in Hypertensive Patients With Diabetes. J Clin Hypertens (Greenwich). 2016 Jun;18(6):528-35. [PMC free article: PMC8032048] [PubMed: 26395174]
Wang KL, Yu WC, Lu TM, Chen LC, Leu HB, Chiang CE. Amlodipine/valsartan fixed-dose combination treatment in the management of hypertension: A double-blind, randomized trial. J Chin Med Assoc. 2020 Oct;83(10):900-905. [PMC free article: PMC7526577] [PubMed: 33009241]
Zhang ZY, Yu YL, Asayama K, Hansen TW, Maestre GE, Staessen JA. Starting Antihypertensive Drug Treatment With Combination Therapy: Controversies in Hypertension - Con Side of the Argument. Hypertension. 2021 Mar 03;77(3):788-798. [PMC free article: PMC7884241] [PubMed: 33566687]
Calhoun DA, Lacourcière Y, Chiang YT, Glazer RD. Triple antihypertensive therapy with amlodipine, valsartan, and hydrochlorothiazide: a randomized clinical trial. Hypertension. 2009 Jul;54(1):32-9. [PubMed: 19470877]
Tita AT, Szychowski JM, Boggess K, Dugoff L, Sibai B, Lawrence K, Hughes BL, Bell J, Aagaard K, Edwards RK, Gibson K, Haas DM, Plante L, Metz T, Casey B, Esplin S, Longo S, Hoffman M, Saade GR, Hoppe KK, Foroutan J, Tuuli M, Owens MY, Simhan HN, Frey H, Rosen T, Palatnik A, Baker S, August P, Reddy UM, Kinzler W, Su E, Krishna I, Nguyen N, Norton ME, Skupski D, El-Sayed YY, Ogunyemi D, Galis ZS, Harper L, Ambalavanan N, Geller NL, Oparil S, Cutter GR, Andrews WW., Chronic Hypertension and Pregnancy (CHAP) Trial Consortium. Treatment for Mild Chronic Hypertension during Pregnancy. N Engl J Med. 2022 May 12;386(19):1781-1792. [PMC free article: PMC9575330] [PubMed: 35363951]
Society for Maternal-Fetal Medicine; Publications Committee. Electronic address: pubs@smfm.org. Society for Maternal-Fetal Medicine Statement: Antihypertensive therapy for mild chronic hypertension in pregnancy-The Chronic Hypertension and Pregnancy trial. Am J Obstet Gynecol. 2022 Aug;227(2):B24-B27. [PubMed: 35710594]
American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 203: Chronic Hypertension in Pregnancy. Obstet Gynecol. 2019 Jan;133(1):e26-e50. [PubMed: 30575676]
Malha L, August P. Safety of Antihypertensive Medications in Pregnancy: Living With Uncertainty. J Am Heart Assoc. 2019 Aug 06;8(15):e013495. [PMC free article: PMC6761622] [PubMed: 31345085]
Yin J, Mei Z, Shi S, Du P, Qin S. Nifedipine or amlodipine? The choice for hypertension during pregnancy: a systematic review and meta-analysis. Arch Gynecol Obstet. 2022 Dec;306(6):1891-1900. [PubMed: 35305140]
Drugs and Lactation Database (LactMed®) [Internet]. National Institute of Child Health and Human Development; Bethesda (MD): Dec 3, 2018. Amlodipine. [PubMed: 29999724]
Abman SH, Hansmann G, Archer SL, Ivy DD, Adatia I, Chung WK, Hanna BD, Rosenzweig EB, Raj JU, Cornfield D, Stenmark KR, Steinhorn R, Thébaud B, Fineman JR, Kuehne T, Feinstein JA, Friedberg MK, Earing M, Barst RJ, Keller RL, Kinsella JP, Mullen M, Deterding R, Kulik T, Mallory G, Humpl T, Wessel DL., American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia; and the American Thoracic Society. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation. 2015 Nov 24;132(21):2037-99. [PubMed: 26534956]
Vukadinović D, Scholz SS, Messerli FH, Weber MA, Williams B, Böhm M, Mahfoud F. Peripheral edema and headache associated with amlodipine treatment: a meta-analysis of randomized, placebo-controlled trials. J Hypertens. 2019 Oct;37(10):2093-2103. [PubMed: 31107359]
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases; Bethesda (MD): Jan 11, 2017. Calcium Channel Blockers. [PubMed: 31643892]
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases; Bethesda (MD): Mar 1, 2016. Amlodipine. [PubMed: 31643900]
Okumuş ÖF. Treatment of Gingival Growth Due to Amlodipine Use With a 445-nm Diode Laser: A Case Report. Cureus. 2022 Dec;14(12):e32592. [PMC free article: PMC9845510] [PubMed: 36660514]
Gandhi S, Fleet JL, Bailey DG, McArthur E, Wald R, Rehman F, Garg AX. Calcium-channel blocker-clarithromycin drug interactions and acute kidney injury. JAMA. 2013 Dec 18;310(23):2544-53. [PubMed: 24346990]
Siriangkhawut M, Tansakul P, Uchaipichat V. Prevalence of potential drug interactions in Thai patients receiving simvastatin: The causality assessment of musculoskeletal adverse events induced by statin interaction. Saudi Pharm J. 2017 Sep;25(6):823-829. [PMC free article: PMC5605837] [PubMed: 28951665]
Savage RD, Visentin JD, Bronskill SE, Wang X, Gruneir A, Giannakeas V, Guan J, Lam K, Luke MJ, Read SH, Stall NM, Wu W, Zhu L, Rochon PA, McCarthy LM. Evaluation of a Common Prescribing Cascade of Calcium Channel Blockers and Diuretics in Older Adults With Hypertension. JAMA Intern Med. 2020 May 01;180(5):643-651. [PMC free article: PMC7042805] [PubMed: 32091538]
Monge-Ortega OP, Domínguez-Ortega J, González-Muñoz M, Cabañas R, Lluch-Bernal M, Fiandor A, Bravo-Gallego LY, Quirce S. [Delayed allergic reaction to amlodipine with a positive lymphocyte transformation test]. Rev Alerg Mex. 2017 Oct-Dec;64(4):505-508. [PubMed: 29249113]
Agarwal MA, Flatt D, Khouzam RN. The potential detrimental effects of calcium channel blockers' overdose and current available management. Ann Transl Med. 2018 Jan;6(1):16. [PMC free article: PMC5787722] [PubMed: 29404362]
de Vries RJ, van Veldhuisen DJ, Dunselman PH. Efficacy and safety of calcium channel blockers in heart failure: focus on recent trials with second-generation dihydropyridines. Am Heart J. 2000 Feb;139(2 Pt 1):185-94. [PubMed: 10650289]
Abernethy DR, Schwartz JB. Pharmacokinetics of calcium antagonists under development. Clin Pharmacokinet. 1988 Jul;15(1):1-14. [PubMed: 3042243]
Zuo XC, Zhou YN, Zhang BK, Yang GP, Cheng ZN, Yuan H, Ouyang DS, Liu SK, Barrett JS, Li PJ, Liu Z, Tan HY, Guo R, Zhou LY, Xie YL, Li ZJ, Li J, Wang CJ, Wang JL. Effect of CYP3A5*3 polymorphism on pharmacokinetic drug interaction between tacrolimus and amlodipine. Drug Metab Pharmacokinet. 2013;28(5):398-405. [PubMed: 23438946]
St-Onge M, Dubé PA, Gosselin S, Guimont C, Godwin J, Archambault PM, Chauny JM, Frenette AJ, Darveau M, Le Sage N, Poitras J, Provencher J, Juurlink DN, Blais R. Treatment for calcium channel blocker poisoning: a systematic review. Clin Toxicol (Phila). 2014 Nov;52(9):926-44. [PMC free article: PMC4245158] [PubMed: 25283255]
Omar S, Parris P, Gurke CR. Hemoadsorption Therapy for Calcium Channel Blocker Overdose: A Case Report. J Emerg Med. 2024 Apr;66(4):e463-e466. [PubMed: 38461133]
Collier DJ, Taylor M, Godec T, Shiel J, James R, Chowdury Y, Ebano P, Monk V, Patel M, Pheby J, Pheby R, Foubister A, David C, Saxena M, Richardson L, Siddle J, Timlin G, Goldsmith P, Deeming N, Poulter NR, Gabe R, McManus RJ, Caulfield MJ. Personalized Antihypertensive Treatment Optimization With Smartphone-Enabled Remote Precision Dosing of Amlodipine During the COVID-19 Pandemic (PERSONAL-CovidBP Trial). J Am Heart Assoc. 2024 Feb 20;13(4):e030749. [PMC free article: PMC11010092] [PubMed: 38323513]
Santschi V, Wuerzner G, Pais B, Chiolero A, Schaller P, Cloutier L, Paradis G, Burnier M. Team-Based Care for Improving Hypertension Management: A Pragmatic Randomized Controlled Trial. Front Cardiovasc Med. 2021;8:760662. [PMC free article: PMC8572997] [PubMed: 34760950]

Disclosure: Kishen Bulsara declares no relevant financial relationships with ineligible companies.

Disclosure: Preeti Patel declares no relevant financial relationships with ineligible companies.

Disclosure: Manouchkathe Cassagnol declares no relevant financial relationships with ineligible companies.

Copyright © 2024, StatPearls Publishing LLC.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

Bookshelf ID: NBK519508PMID: 30137793


  • PubReader
  • Print View
  • Cite this Page

Related information

  • PMC
    PubMed Central citations
  • PubMed
    Links to PubMed

Similar articles in PubMed

See reviews...See all...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...