Amlodipine

Amlodipine is a medicine used to treat high blood pressure (hypertension).

If you have high blood pressure, taking amlodipine helps prevent future heart disease, heart attacks and strokes.

Amlodipine is also used to prevent chest pain caused by heart disease (angina).

This medicine is only available on prescription. It comes as tablets or as a liquid to swallow.

• Amlodipine lowers your blood pressure and makes it easier for your heart to pump blood around your body.
• It's usual to take amlodipine once a day. You can take it at any time of day, but try to make sure it's around the same time each day.
• The most common side effects include headache, flushing, feeling tired and swollen ankles. These usually improve after a few days.
• Amlodipine can be called amlodipine besilate, amlodipine maleate or amlodipine mesilate. This is because the medicine contains another chemical to make it easier for your body to take up and use it. It doesn't matter what your amlodipine is called. They all work as well as each other.
• Amlodipine is also called by the brand names Istin and Amlostin.

Amlodipine can be taken by adults and children aged 6 years and over.

Amlodipine is not suitable for some people.

To make sure amlodipine is safe for you, tell your doctor if you:

• have had an allergic reaction to amlodipine or any other medicines in the past
• are trying to get pregnant, are already pregnant or you're breastfeeding
• have liver or kidney disease
• have heart failure or you have recently had a heart attack

Take amlodipine exactly as your doctor has told you, and follow the directions on the label. If you're not sure, check with your doctor or pharmacist.

It's usual to take amlodipine once a day. You can take amlodipine at any time of day, but try to make sure it's around the same time every day.

How much to take

Amlodipine comes as 5mg and 10mg tablets.

Depending on why you're taking amlodipine, the usual starting dose is 5mg once a day.

If the starting dose isn't working well enough (your blood pressure doesn't lower enough, or your angina isn't controlled), you may need to increase your dose to 10mg.

To decide the correct dose for you in the longer term, your doctor will check your blood pressure to make sure it's not too high or too low. They'll also ask if you're getting any side effects from the medicine.

Doses may be lower for children.

How to take it

You can take amlodipine with or without food.

Swallow amlodipine tablets whole with a drink of water. If it's easier, you can dissolve the tablets in a glass of water, but you must drink it all straight away if you do this.

Do not eat or drink lots of grapefruit or grapefruit juice while you're taking this medicine. Grapefruit can increase the concentration of amlodipine in your body and worsen side effects.

If you're taking amlodipine as a liquid, it'll come with a plastic syringe or spoon to help you measure out the right dose. If you don't have one, ask your pharmacist for one.

Do not use a kitchen teaspoon as it will not give the right amount of medicine.

Do not mix the liquid with food or other drinks before taking it.

Important

Take amlodipine even if you feel well, as you'll still be getting the benefits of the medicine.

What if I forget to take it?

If you forget to take a dose of amlodipine, take it as soon as you remember that day and then carry on as normal.

If you forget to take the dose for the whole day, skip the missed dose and carry on as normal the next day.

Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

If you take too much amlodipine by accident, contact your doctor or go to your nearest hospital straight away.

An overdose of amlodipine can cause dizziness and sleepiness.

The amount of amlodipine that can lead to an overdose varies from person to person.

Call your doctor or go to A&E straight away if:

Like all medicines, amlodipine can cause side effects, although not everyone gets them.

Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects happen in more than 1 in 100 people. They're usually mild and short-lived.

Talk to your doctor or pharmacist if the side effects bother you or last for more than a few days:

• headaches
• feeling dizzy
• flushing
• a pounding heartbeat
• swollen ankles

Serious side effects

Serious side effects after taking amlodipine are rare and happen in less than 1 in 10,000 people.

Call a doctor straight away if you get:

• stomach problems – severe pain in your stomach, with or without bloody diarrhoea, feeling sick and being sick (nausea and vomiting) can be signs of pancreatitis
• yellow skin or the whites of your eyes turn yellow – this can be a sign of liver problems
• chest pain that's new or worse – this needs to be checked out as chest pain is a possible symptom of a heart attack

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to amlodipine.

These aren't all the side effects of amlodipine.

For a full list, see the leaflet inside your medicine packet.

What to do about:

• headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking amlodipine. Talk to your doctor if they last longer than a week or are severe.
• feeling dizzy – if amlodipine makes you feel dizzy, stop what you're doing and sit or lie down until you feel better
• flushing – try cutting down on coffee, tea and alcohol. It might help to keep the room cool and use a fan. You could also spray your face with cool water or sip cold or iced drinks. The flushing should go away after a few days. If it doesn't go away or it's causing you problems, contact your doctor.
• a pounding heartbeat – if this happens regularly after you take your medicine, try to take amlodipine at a time when you can sit down (or lie down) when the symptoms are at their worst. It may help to cut down on alcohol, smoking, caffeine and big meals as these may make the problem worse. If you're still having problems after a week, speak to your doctor as they may need to change you to a different type of medicine.
• swollen ankles – raise your legs when you're sitting down

Amlodipine is not normally recommended in pregnancy or when breastfeeding.

If you're trying to get pregnant or you're already pregnant, talk to your doctor about the benefits and possible harms of taking amlodipine. There may be other medicines that are safer for you.

For more information about how amlodipine can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

Amlodipine and breastfeeding

Small amounts of amlodipine may get into breast milk, but it's not known if this is harmful to the baby.

Talk to your doctor as other medicines might be better while you're breastfeeding.

If you take other medicines that lower blood pressure, such as ramipril or lisinopril, at the same time as amlodipine, the combination can sometimes lower your blood pressure too much.

This may make you feel dizzy or faint. If this keeps happening to you, tell your doctor as your dose may need to be changed.

Some medicines can interfere with the way amlodipine works.

Tell your doctor if you're taking any of these medicines before starting amlodipine:

• the antibiotics clarithromycin, erythromycin or rifampicin
• medicines for high blood pressure, including diltiazem and verapamil
• the antifungals itraconazole or ketoconazole
• medicines to treat HIV or HCV (hepatitis C virus)
• the anti-epilepsy medicines carbamazepine, phenytoin, phenobarbital (phenobarbitone) or primidone
• medicines to suppress your immune system, such as ciclosporin or tacrolimus
• more than 20mg a day of the cholesterol-lowering medicine simvastatin

Mixing amlodipine with herbal remedies or supplements

St John's wort, a herbal medicine taken for depression, is thought to interfere with the way amlodipine works.

Talk to your doctor if you're thinking about taking St John's wort.