Amlodipine

Pronunciation: am-LOW-dih-peen.

Generic name
amlodipine (as amlodipine besylate/besilate)
Drug class
Calcium channel blocker (dihydropyridine class)
Form
Tablet (2.5 mg, 5 mg, 10 mg)
Route
Oral
Legal status
Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Norvasc (and generics: Amlodipine-WGR, APX-Amlodipine, Amlodipine-RJIC) (5) · Full directory

What amlodipine (as amlodipine besylate/besilate) is and how it works

Amlodipine is a prescription-only calcium channel blocker used to treat high blood pressure (hypertension) and certain types of chest pain (angina). It works by relaxing and widening blood vessels, making it easier for the heart to pump blood. (1)

Take amlodipine exactly as your prescriber directs, usually once a day at the same time. Your starting dose and any adjustments are individually determined based on your blood pressure, other health conditions, and how you respond -- there is no single dose for everyone.

Mechanism of action: how amlodipine (as amlodipine besylate/besilate) works

Amlodipine is a long-acting dihydropyridine calcium channel blocker that inhibits transmembrane calcium ion influx into vascular smooth muscle and, to a lesser extent, cardiac muscle, producing peripheral vasodilation and reduced peripheral vascular resistance, with a relatively low risk of reflex tachycardia compared to shorter-acting calcium channel blockers due to its slow onset of action. (1)

What amlodipine (as amlodipine besylate/besilate) is used for

High blood pressure (hypertension)

Used to lower blood pressure, which reduces the risk of serious cardiovascular events such as stroke and heart attack. (1)

Chronic stable angina and vasospastic (Prinzmetal's) angina

Used to reduce the frequency of chest pain episodes caused by reduced blood flow to the heart, including angina caused by coronary artery spasm. (1)

Coronary artery disease

Used in some patients with angiographically documented coronary artery disease who do not have heart failure or significantly reduced heart pumping function. (1)

Before taking amlodipine (as amlodipine besylate/besilate)

Do not take / not appropriate for

  • Do not take amlodipine if you have had an allergic reaction to amlodipine or other dihydropyridine calcium channel blockers. (all countries) (1) (2)
  • Do not take amlodipine if you have severely low blood pressure, are in shock, have significant obstruction of blood flow out of the heart's left ventricle (such as severe aortic stenosis), or have unstable heart failure following a recent heart attack. (United Kingdom) (2)

Tell your clinician about

  • Any history of heart failure, heart valve problems (especially aortic stenosis), or a recent heart attack.
  • Any liver problems, since amlodipine is broken down more slowly and levels can build up more in significant liver impairment.
  • All other medicines you take, especially simvastatin (a cholesterol medicine) and any other medicines that affect the CYP3A4 liver enzyme.
  • Pregnancy, plans for pregnancy, or breastfeeding.
(1) (2)

How to take amlodipine (as amlodipine besylate/besilate)

  • Swallow the tablet once daily, with or without food, at around the same time each day.
  • Do not stop or change your dose without discussing it with your prescriber first, even if you feel well.
  • It may take a few weeks for the full blood-pressure-lowering effect to develop.
(1) (2)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose, in which case skip the missed dose -- do not take a double dose to make up for it. Contact your prescriber or pharmacist if unsure.

Overdose

Seek urgent medical attention if too much amlodipine has been taken, or if symptoms such as marked dizziness, fainting, or a very fast or weak heartbeat occur, since overdose can cause significant low blood pressure and a reflex fast heart rate. Amlodipine is highly protein-bound, so dialysis is unlikely to help remove it from the body. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Swelling of the ankles or legs (peripheral oedema) -- the most common side effect, and more likely at higher doses.

What to notice: Swelling of the ankles or legs (peripheral oedema) -- the most common side effect, and more likely at higher doses.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Dizziness, headache, and flushing.

What to notice: Dizziness, headache, and flushing.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Tiredness (fatigue) and sleepiness (somnolence).

What to notice: Tiredness (fatigue) and sleepiness (somnolence).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Palpitations and nausea or abdominal pain.

What to notice: Palpitations and nausea or abdominal pain.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Serious warnings

Worsening chest pain (angina) or signs of a heart attack — emergency

Symptoms: New or worsening chest pain, chest pressure or tightness, pain spreading to the arm or jaw, breathlessness, or sweating -- this can occur especially shortly after starting or increasing the dose in people with significant underlying coronary artery disease.

Action: Seek emergency medical help immediately for these symptoms. (1)

Signs of significant low blood pressure — high caution

Symptoms: Severe dizziness, lightheadedness, or fainting, particularly in people with severe aortic valve narrowing (aortic stenosis).

Action: Tell your prescriber promptly -- this caution is particularly relevant for people with severe aortic stenosis or other conditions predisposing to low blood pressure. (1) (2)

Signs of worsening heart failure — high caution

Symptoms: Increasing shortness of breath, swelling of the legs or abdomen, or sudden weight gain.

Action: Tell your prescriber promptly if these occur -- amlodipine is used cautiously in heart failure with ongoing monitoring. (2)

Interactions

  • Simvastatin (a cholesterol-lowering statin): when combined with amlodipine, the simvastatin dose is generally capped at 20 mg daily, because amlodipine increases simvastatin levels in the body by around 77%, raising the risk of muscle-related side effects. (1) (2)
  • Strong or moderate CYP3A4-inhibitor medicines can raise amlodipine levels and increase the risk of low blood pressure -- your prescriber may need to adjust your dose. (1) (2)
  • Grapefruit juice is generally not recommended with amlodipine, as it may increase how much amlodipine the body absorbs. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Safety in human pregnancy has not been firmly established. Animal studies did not show clear evidence of birth defects, though effects on litter size were seen at high doses in some animal studies. Use only if the potential benefit is judged to outweigh the risk, in discussion with your prescriber. (1) (2) (3) (4) (5) (6)

Breastfeeding

Amlodipine passes into breast milk in small amounts. Discuss the balance of benefits and risks with your prescriber before use while breastfeeding. (1) (2) (3) (4) (5) (6)

Children

May be used in children aged 6-17 years for hypertension in some countries, typically starting at a lower dose (e.g. 2.5 mg once daily) with careful titration; higher doses have not been well studied in this age group. (1) (2) (3) (4) (5) (6)

Elderly

Often started at a lower dose and increased more cautiously, since elderly patients may be more sensitive to blood-pressure-lowering effects. (1) (2) (3) (4) (5) (6)

Hepatic_impairment

Amlodipine is broken down more slowly in significant liver impairment, increasing drug levels -- a lower starting dose and slower, more cautious titration is generally used. (1) (2) (3) (4) (5) (6)

Renal_impairment

Amlodipine can generally be used at normal doses in kidney impairment, as changes in blood levels do not correlate closely with the degree of kidney impairment, but discuss with your prescriber. (1) (2) (3) (4) (5) (6)

Monitoring

Before starting

  • Baseline blood pressure and heart rate
  • Review of heart valve disease (especially aortic stenosis) and heart failure history
  • Review of liver function where relevant
  • Review of other medicines, especially simvastatin and other statins

During treatment

  • Regular blood pressure monitoring to guide dose adjustments.
  • Monitoring for ankle swelling and other dose-related side effects.
  • Monitoring for worsening angina symptoms, especially after starting or increasing the dose.
(1)

Storage

Store at controlled room temperature (about 15-30°C / 59-86°F), in the original container, protected from light and moisture, out of reach and sight of children.

Study the drug class: Dihydropyridine calcium channel blockers

Professional information

Clinician-facing context only, sourced from the current US FDA prescribing information and UK emc SmPC; verify against the current full label in the relevant jurisdiction before prescribing.

United States

Indication: Hypertension, chronic stable and vasospastic angina, coronary artery disease

Dose summary: Usual initial dose 5 mg once daily orally, maximum 10 mg once daily. Small, fragile, or elderly patients, or those with hepatic insufficiency: consider starting at 2.5 mg once daily.

Renal context: No specific dose adjustment required based on renal impairment alone; amlodipine is highly protein-bound and not effectively removed by haemodialysis. (1)

United Kingdom

Indication: Hypertension, chronic stable and vasospastic angina

Dose summary: Usual initial dose 5 mg once daily, maximum 10 mg once daily. Children 6-17 years: 2.5 mg once daily initially, up-titrated to 5 mg if needed (not studied above 5 mg/day in this age group).

Renal context: Normal dosing generally recommended; plasma concentration changes do not correlate closely with degree of renal impairment. (2)

Mechanism of action

Hepatic guidance

Hepatic impairment prolongs amlodipine's half-life and increases systemic exposure -- use a lower starting dose and titrate slowly.

Overdose note

Overdose can cause excessive peripheral vasodilation with marked and prolonged systemic hypotension, and possibly reflex tachycardia; manage with active cardiac and respiratory monitoring, elevation of the limbs, and attention to circulating fluid volume; amlodipine is highly protein-bound so haemodialysis is unlikely to be beneficial. (1)

Frequently asked questions

Is amlodipine available in the US, UK, Europe, Canada, Australia, and New Zealand?

Yes, it is approved and available in all of these regions, both as the original brand Norvasc and as generic amlodipine. (1) (2) (3) (4) (5) (6)

Why does amlodipine cause ankle swelling?

Amlodipine widens blood vessels, particularly small arteries, more than it widens veins. This imbalance can lead to fluid shifting into the tissues of the lower legs and ankles, causing swelling. It is dose-related and is the most commonly reported side effect. (1) (2)

Can I take amlodipine with simvastatin?

Yes, but the simvastatin dose is generally limited to 20 mg daily when combined with amlodipine, because amlodipine increases simvastatin levels in the body and this combination raises the risk of muscle-related side effects at higher simvastatin doses. (1) (2)

What is the mechanism of action of amlodipine (as amlodipine besylate/besilate)?

Amlodipine is a long-acting dihydropyridine calcium channel blocker that inhibits transmembrane calcium ion influx into vascular smooth muscle and, to a lesser extent, cardiac muscle, producing peripheral vasodilation and reduced peripheral vascular resistance, with a relatively low risk of reflex tachycardia compared to shorter-acting calcium channel blockers due to its slow onset of action. (1)

What is the generic name of Amlodipine?

The generic name is amlodipine (as amlodipine besylate/besilate). (1)

What class of drug is amlodipine (as amlodipine besylate/besilate)?

Amlodipine is classed as: Calcium channel blocker (dihydropyridine class). (1)

References

  1. NORVASC (amlodipine besylate) Tablets -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Pfizer · United States · accessed 2026-07-29 · source 1
  2. Amlodipine 5mg Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-29 · source 2
  3. Norvasc and associated names (amlodipine) -- Article 30 referral / EU harmonisationEuropean Medicines Agency (EMA) · European Union · accessed 2026-07-29 · source 3
  4. NORVASC (amlodipine besylate) Product MonographHealth Canada product monograph (NORVASC, Viatris/Pfizer/Upjohn Canada) · Canada · accessed 2026-07-29 · source 4
  5. NORVASC (amlodipine) -- ARTG registrationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 5
  6. Norvasc / Apo-Amlodipine -- New Zealand Data SheetsMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-29 · source 6

Brand names by country

Single-ingredient amlodipine (as amlodipine besylate/besilate) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Norvasc (and generic amlodipine besylate) (1)FDA approved currently labeled since 1992 · 2.5 mg, 5 mg, 10 mg · Pfizer

United Kingdom

  • Amlodipine (generic; originally Istin) (2)MHRA licensed emc smpc confirmed · 5 mg, 10 mg · various generic manufacturers

Canada

  • Norvasc (and generics) (4)Health Canada approved confirmed · 2.5 mg, 5 mg, 10 mg · Pfizer Products Inc. / Upjohn Canada ULC

Australia

  • Norvasc (and generics: Amlodipine-WGR, APX-Amlodipine, Amlodipine-RJIC) (5)TGA ARTG registered 1993-02-26 confirmed · 5 mg, 10 mg · Pfizer Australia Pty Ltd (Norvasc); various generic sponsors

New Zealand

  • Norvasc (and generic, e.g. Apo-Amlodipine) (6)Medsafe approved confirmed · 2.5 mg, 5 mg, 10 mg · Pfizer New Zealand Limited; generic sponsors
View brands in additional countries.

European Union

Norvasc (and national generics) (3)

This page provides general reference information about amlodipine and is not a substitute for advice from the prescriber managing your treatment. All dosing and treatment decisions should be made with your prescriber.

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