Amlodipine Side Effects

Amlodipine Side Effects You Should Know About

High blood pressure (hypertension) is a disease that almost half of the adults in the U.S. have and was a primary or contributing cause of more than 670.000 deaths in 2020 (1). In most cases, hypertension is manageable with medications. Yet, it is a disease mostly without symptoms, and if untreated, hypertension increases the risk of heart attack, stroke, or kidney failure (2).

Medications like amlodipine alone or in combination help control high blood pressure (1). But what about the side effects? How concerning are the amlodipine side effects? (3)

This article is about amlodipine’s side effects. Keep reading to learn what conditions you can manage yourself and when to call healthcare providers. Also, find the additional American Heart Association (AHA) recommendations for high blood pressure regulation.

What is Amlodipine?

Amlodipine is a calcium channel blocker. By blocking the calcium from entering “slow channels,” amlodipine relaxes the coronary vascular smooth muscle and causes vasodilation, increasing oxygen delivery to the heart muscle. (4)

Thanks to this mechanism, amlodipine is used alone or in combination with other drugs to treat the following conditions.

High Blood Pressure

High blood pressure is higher than the normal pressure that blood exerts on the arteries’ walls. It can happen if the arteries are narrower, stiffer, or if the heart pumps blood more vigorously. (2)

Amlodipine relaxes the blood vessels, and thus, the heart doesn’t need extra effort to pump blood. Regulated blood pressure reduces the risk of brain, heart, blood vessels, and kidney damage and prevents a heart attack or stroke. (3, 5)

Angina

Angina is a type of chest pain when the heart muscle itself doesn’t get enough blood supply. Usually, this pain occurs in the chest under the breastbone. The pain can also appear in the shoulders, neck, arms, jaws, or back. Amlodipine increases the blood supply to the heart and can reduce angina. Regular treatment with amlodipine can control the chest pain but cannot stop it when started. (3, 5)

What Are the Possible Amlodipine Side Effects?

Amlodipine has been used for 30 years, and most of the side effects are well known. However, when using it for the first time, the body needs some time to adjust to the medicine; often, side effects that occur at the beginning improve over time.

Edema is the most common side effect of amlodipine, and its occurrence can depend on the dosage. Other adverse experiences that may happen in more than 1% of the patients are fatigue, nausea, and abdominal pain.

Most of the side effects are mild to moderate:

• swelling of your legs or ankles;
• tiredness, extreme sleepiness;
• stomach pain, nausea;
• dizziness;
• flushing (hot or warm feeling on your face);
• arrhythmia (irregular heartbeat);
• heart palpitations (very fast heartbeat);
• muscle rigidity, tremor, or abnormal muscle movement. (3)

Side Effects That You Self-Manage

In case of mild side effects, you might find England’s National Health Service recommendations helpful to help manage your symptoms: (6)

Headaches – Headaches usually disappear after a week of taking amlodipine. Get rest and intake fluids. Avoid alcohol. Get advice from a pharmacist if you need a painkiller. If the headache stays for over a week, consult your physician;

Dizziness – If you feel dizzy, sit or lie until you feel better. Then, from a lying position, sit and wait for a while, and then stand up slowly. Avoid driving, operating machinery and tools, or riding a bike until the dizziness disappears;

Flushing – Reduce coffee, tea, and alcohol consumption. Stay in a cool room, freshen your face with cool water, and get cold drinks;

A pounding heartbeat – If it regularly happens to you after taking amlodipine, try taking amlodipine at a time of day when you can rest until the symptoms subside. Avoid alcohol, tea, coffee, smoking, and big meals. (6)

However, the best way is to consult your doctor if any adverse reaction appears.

Serious Side Effects

If you experience any of the following symptoms, call your doctor immediately or emergency:

Pancreatic problems – Severe pain in the stomach, nausea and vomiting, and diarrhea with or without blood can be signs of pancreatitis. (7)

Liver problems – In case of liver injury, the whites of your eyes turn yellow, or your skin becomes yellow (jaundice).

Chest pain – If you have angina and the chest pain does not stop after a few minutes or is new or worse than previously, it can be a sign of worsening angina or a heart attack.

Allergic reactions – People allergic to amlodipine must not take this medication. However, in case you don’t know, the symptoms suggesting an allergic reaction include skin rash, itching, red or swollen skin, wheezing, tightened chest or throat, trouble with breathing or talking, or swelling of the mouth, face, lips, tongue, or throat (6).

Erythema Multiforme – It is a severe skin reaction that can cause red and itchy skin with characteristic “target” lesions.

Warning and Precautions

Rarely, when introducing amlodipine, the patient may have a heart attack or angina get worse, particularly those patients with severely occluded coronary arteries. If this happens to you, call the emergency right away or go to a hospital emergency room. (3)

Hypotension is possible in patients with severe aortic stenosis (a condition in which the aortic valve of the heart cannot open fully and allow oxygenated blood to go to the body). (8) Acute hypotension is unlikely because the amlodipine exerts its effects gradually. (3)

If you have impaired liver function, your doctor will initiate treatment with half the normal dose and increase it slowly. Amlodipine is metabolized in the liver and has a half-life of 56 hours in cases of hepatic impairment. (3)

How Should You Take Amlodipine?

Amlodipine tablets are available in doses of 2.5 mg, 5 mg, and 10 mg. The initial dose in adults is 5 mg and can be increased to 10 mg daily. In children, the doctor can start treatment with 2.5 mg and increase, if needed, to a 5 mg daily dose.

Take the recommended dose once a day, every day, possibly at the same time. If you miss the dose, take it as soon as you realize it, except if 12 hours have passed since the last dose. In such a case, wait until the time for the next dose comes. If you took too much amlodipine, call your doctor or poison center, or go to the emergency care unit in the closest hospital immediately.

Check with your doctor if you need to take any new prescription or over-the-counter medication. Amlodipine interacts with some medicines. Therefore, the doctor knows which medication can be used with amlodipine. (3)

American Heart Association Blood Pressure Guidance

Amlodipine or any other medication alone may not be sufficient to control your hypertension until you make lifestyle changes and introduce healthy habits. American Heart Association (AHA) recommends the following changes to help manage hypertension: (9)

Eat a well-balanced diet with low salt content – Introduce a diet with fresh fruits and vegetables, low-fat dairy products, whole grains, fish, olive oil, nuts, and legumes. Dietary Approaches to Stop Hypertension (DASH) limits red meat, salt, sweets, and sugar-sweetened beverages.

Limit alcohol – Too much alcohol can increase blood pressure. Therefore, limit daily alcohol consumption to two drinks per day for men and one drink per day for women.

Enjoy regular physical activity – Regular physical activity is beneficial for high blood pressure and weight regulation, strengthens the heart, and reduces stress. AHA recommends at least 150 minutes of moderate-intensity physical activity per week, spread into several days. It should include flexibility and stretching exercises and muscle-strengthening activities. You can choose from brisk walking, hiking or stair-climbing, jogging, bicycling, swimming, fitness, team sports, or dance classes, whatever activity is best for you.

Manage stress – There are simple ways to reduce the stress that is a risk factor for high blood pressure. Talking with family or friends, improving time management, learning how to say “No,” accepting things that are out of your control, or finding time to relax are some of the ways you can implement.

Maintaining a healthy weight – Being overweight increases the risk of high blood pressure and other health problems, puts extra strain on the heart, and can damage blood vessels. A healthy diet plus physical activity can do a lot to help you lose a few pounds and maintain a healthy weight.

Quit smoking – Smoking is a risk factor for heart attack or stroke and increases the risk of building up fatty substances in the arteries. For these and many other conditions where smoking is a risk factor, you should quit and continue to live a healthier life.

Many of the above recommendations are easy to implement, and willpower is the only thing you need for it. For those changes that you tried and failed or don’t know how to do it effectively, consult your doctor. Working together with your doctor can help you in making healthy life changes.

Final Thoughts

High blood pressure comes over time and needs a comprehensive approach to be managed. Amlodipine is a proven medication with well-known side effects. Although many side effects are mild-moderate and transitory, serious ones need more attention and self-awareness to act accordingly.

Your doctor or pharmacist can help you learn all you need and support you in an emergency. If you experience serious side effects, call your doctor or go to the hospital emergency room. Report events that make you feel bad.

Make additional beneficial lifestyle changes for your high blood pressure and other health conditions. Keep looking for your well-being before it is too late; it is the best thing you can do for yourself.

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