Amlodipine: Price, Dosage & Where to Buy

Amlodipine is a calcium channel blocker prescribed most commonly to lower high blood pressure, and also used for the chest pain of coronary artery disease, including chronic stable angina and vasospastic angina. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, chiefly strokes and myocardial infarctions. Amlodipine requires a prescription in the United Kingdom, and a generic form has been available since 23 May 2007.

Amlodipine is used for high blood pressure, also called hypertension. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, mainly strokes and myocardial infarctions, which are heart attacks. It may be used on its own or alongside other blood pressure medicines, and many patients need more than one medicine to reach their blood pressure goal.

Control of high blood pressure is normally part of wider cardiovascular risk management, which can include lipid control, diabetes management, antithrombotic therapy, stopping smoking, exercise and limited sodium intake. The second area of use is coronary artery disease. Amlodipine is indicated for the symptomatic treatment of chronic stable angina, and for confirmed or suspected vasospastic angina, also known as Prinzmetal's or variant angina.

In patients whose coronary artery disease has recently been documented by angiography, and who do not have heart failure or an ejection fraction below 40%, it is indicated to reduce the risk of hospitalisation for angina and to reduce the risk of a coronary revascularisation procedure. For angina it may be used alone or with other antianginal medicines.

Amlodipine belongs to the group of medicines known as calcium channel blockers. The muscle cells in artery walls need calcium to move in through tiny channels before they can contract. Amlodipine blocks those channels in the smooth muscle of blood vessels, so the muscle relaxes and the arteries widen.

Wider arteries offer less resistance to blood flow, so the pressure inside them falls and the heart does not have to work as hard to move blood around the body. The same relaxing effect helps in angina. Widening the arteries reduces the workload on the heart, which lowers the amount of oxygen the heart muscle needs.

In vasospastic angina, where a coronary artery goes into spasm and narrows, relaxing that artery wall helps blood flow through it again. Amlodipine has a gradual onset of action, which is why its effect builds over time and why a sudden fall in blood pressure is unlikely. It controls blood pressure and angina while treatment continues, rather than altering the underlying condition permanently.

The label lists 2.5 mg, 5 mg and 10 mg tablets, plus an oral solution and an oral suspension at 1 mg/mL. The usual starting dose is 5 mg once daily for an adult treated for high blood pressure. The label lists a maximum of 10 mg once daily.

The label lists 2.5 mg once daily as the starting point for small, fragile or elderly patients and for those with hepatic insufficiency. The label lists a general interval of 7 to 14 days between titration steps, with dosage adjusted according to blood pressure goals. The label lists 5 to 10 mg for chronic stable or vasospastic angina, with the lower end suggested in elderly patients and in hepatic insufficiency, and notes that most patients require 10 mg for adequate effect.

The label lists 5 to 10 mg once daily for coronary artery disease. The label lists 2.5 mg to 5 mg once daily for children aged 6 to 17 years, and states that doses above 5 mg daily have not been studied in children.

Amlodipine has a gradual onset of action and a long-lasting effect, so one missed dose does not usually cause an immediate problem. Standard pharmacy counselling is that a missed dose can be used when remembered on the same day, and left out if the next one is nearly due; doubling up to make up a missed dose is not advised.

Blood pressure and angina are controlled only while treatment continues, so regular daily use matters. Anyone unsure should ask a pharmacist or prescriber.

The label states that the limited available data from post-marketing reports in pregnant women are not sufficient to inform a drug-associated risk of major birth defects or miscarriage. It also notes risks to mother and baby from poorly controlled high blood pressure in pregnancy, including pre-eclampsia, gestational diabetes, premature delivery and delivery complications, and advises that pregnant women with hypertension be carefully monitored.

For breastfeeding, a published lactation study reported amlodipine in human milk at an estimated median relative infant dose of 4.2%, with no adverse effects observed in breastfed infants and no information available on milk production. Pregnancy and breastfeeding should be discussed with a doctor or pharmacist.

The label states storage at 20°C to 25°C, described as controlled room temperature, and dispensing in tight, light-resistant containers. Tablets should therefore be kept in their original container, away from direct light and damp places such as bathrooms, to maintain quality. As with all medicines, they should be kept out of the sight and reach of children and used as directed on the label.