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Key takeaways
Amlodipine is a commonly prescribed medication for certain cardiovascular conditions like high blood pressure and angina.
The dose of amlodipine is often started low and titrated to a desired effect, such that a dose of 10 mg of amlodipine is considered a moderate dose.
There are serious side effects associated with amlodipine, some—like hypotension—are dose-dependent. The medication should therefore be stored safely and out of reach of children. Medical attention should be sought if consumed outside of provider-recommended parameters or in the setting of the development of adverse side effects, like an allergic reaction or irregular heartbeat.
Amlodipine is a dihydropyridine member of the calcium channel blocker medication class, and is used to manage chronic high blood pressure and angina—a form of chest pain that occurs when the heart muscle doesn’t receive sufficient oxygen-rich blood. Amlodipine has also been used off-label for Raynaud’s phenomenon. Amlodipine doses typically range from 2.5 mg once daily to a maximum daily dose of 10 mg once daily for its FDA-approved indications of angina and chronic hypertension; doses of up to 20 mg per day have been used in the off-label management of Raynaud phenomenon. Generally, patients are initiated on lower doses and titrated up on dose slowly to the dose providing the desired effect, or to the maximum daily dose.
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What is amlodipine 10 mg used for?
Amlodipine 10 mg for chronic hypertension is usually limited to those patients warranting combination therapy, with blood pressure more than 20/10 mmHg above goal or with a suboptimal response to monotherapy. Amlodipine 10 mg in these patients would most often be combined with a medication from another prescription drug class for chronic hypertension, like an angiotensin-converting enzyme (ACE) inhibitor, angiotensin II receptor blocker (ARB), or thiazide diuretic. Depending upon the clinical scenario, and whether amlodipine is being added onto another blood pressure medication or is the sole medication prescribed, doses will likely be started on the lower end of normal and titrated to effect. The degree to which amlodipine lowers blood pressure will be specific to the individual, but generally provides a substantial impact, with one particular study looking at this effect demonstrating a reduction of 14.2 mmHg in systolic blood pressure and 13.6 mmHg in diastolic blood pressure with amlodipine 10 mg at the end of 8 weeks. The ultimate dose of amlodipine 10 mg in the range of dosing is on the highest end of the spectrum for this indication.
In angina, the use of amlodipine 10 mg can be seen in the management of both vasospastic angina and chronic stable angina. In chronic stable angina, amlodipine 10 mg would be considered an alternative therapy to first-line therapies like beta blockers in those patients who do not achieve resolution of symptoms or in those for whom there are contraindications or unacceptable adverse effects associated with the use of beta-blocker prescription drugs.
Amlodipine is one of the only calcium channel blockers that may be used in patients with heart failure with reduced ejection fraction (HfrEF), where it may be administered either for the treatment of high blood pressure or ischemic heart disease, possibly due to coronary artery disease in such patients. It does not, however, have any effect on functional status or mortality in these individuals.
When used in the therapeutic management of Raynaud phenomenon, amlodipine 10 mg is used to relax and open blood vessels to improve circulation in those whom suffer from this condition; given its effect on blood pressure, these patients must be monitored closely for amlodipine’s impact, particularly since some patients require doses beyond the typical maximum daily dose seen in management of chronic hypertension and angina-up to 20 mg per day.
What to expect when taking it
Amlodipine can be administered without regard to meals. It is available as a tablet in 2.5 mg, 5 mg, and 10 mg strengths. Amlodipine is also available as an oral solution with a 1 mg/mL concentration. The peak impact on blood pressure is delayed, such that dose titrations should occur slowly and generally not until 7 to 14 days after a given dose is trialed and monitored. The most significant adverse effect of amlodipine is peripheral edema, characterized by ankle and leg swelling. This side effect can be bothersome to patients but often subsides within a few days following intervention. This is a dose-related effect, so it may be more commonly seen in patients taking amlodipine 10 mg versus lower daily doses. Other common adverse reactions occurring in approximately 1 to 10% of patients include flushing, heart palpitations, nausea, dizziness (particularly in doses exceeding 5 mg/day), and fatigue.
Amlodipine 10 mg vs. 5 mg
Typically, the decrease in blood pressure observed with the consumption of amlodipine is dose-dependent. It therefore isn’t unexpected that the observed decrease in blood pressure as the dose is titrated from 5 mg to 10 mg decreases both systolic and diastolic blood pressure, as observed in retrospective analyses. In some patients, the additional increase in amlodipine dose from 5 mg to 10 mg decreased systolic blood pressure by 12.5 mmHg and diastolic blood pressure by 6 mmHg. It is important to take your medication, monitor blood pressure as a healthcare professional advises, and titrate the medication based on their medical advice.
How to take amlodipine 10 mg
Amlodipine 10 mg should be taken as advised by a healthcare provider. Generally, this dose will not be initiated upfront, but amlodipine will be titrated from a starting dose of 2.5 mg or 5 mg. Its available dosage forms include liquid formulations and an oral tablet, which should be swallowed whole, and either can be taken without regard to meals. It is most commonly a once-daily medication, and patients should attempt to take it around the same time each day to maintain consistent blood levels. Follow your healthcare provider’s advice regarding monitoring for effects, including monitoring blood pressure at home to check for low or insufficiently lowered blood pressure. If you’ve forgotten to take a dose, take the dose as soon as you remember. However, if it is almost time for your next dose, do not double up the dose to account for a missed dose. Eating grapefruit and/or drinking grapefruit juice while on amlodipine should generally be avoided as concomitant consumption can increase the blood levels of amlodipine; if nothing else, consistent consumption is advised.
How much does amlodipine 10 mg cost?
Amlodipine besylate tablets are a generic medication of the brand name Norvasc, which is fortunately reflected in its price; 30 tablets of amlodipine 10 mg will cost about $65 without any insurance or medication coupon. Given that it is a generic medication, amlodipine 10 mg is often covered by insurance plans; the copay or coinsurance amount paid out of pocket will vary depending on the insurance plan’s formulary. Using a SingleCare prescription drug discount card, that price can drop to as low as $6 for 30 tablets of amlodipine 10 mg.
The oral solution is available as the branded prescription drug Norliqva, and the oral suspension is available as the brand-name prescription medication Katerzia. Given their brand-name-only formulations, these medications are likely to cost more out of pocket and, if covered by an insurance plan, carry a higher copayment.
Amlodipine 10 mg alternatives
While amlodipine 10 mg is a well-tolerated medication by most, some patients may seek alternatives due to serious side effects, particularly swelling in the ankles or legs, dizziness, headache, tiredness, and flushing. Amlodipine has several significant drug interactions with medications like simvastatin, tacrolimus, or cyclosporine, which may necessitate a change in therapy. Alternatives to amlodipine may also be sought in certain patient populations, like pregnant women or women who are breastfeeding, as well as in those with severe aortic stenosis, underlying liver disease, or unstable heart failure after a heart attack. Fortunately, for its FDA-approved indications of management of chronic hypertension and angina, there is a large armamentarium of alternative medications available. It is therefore important to be open with your healthcare provider about any unwanted side effects while taking amlodipine 10 mg so they can help design a personalized treatment plan; never abruptly stop taking the medication without consulting with your provider. If an alternative medication is recommended, the antihypertensive effects of amlodipine will last anywhere from 24 to 72 hours after discontinuation. Generally, alternatives can be initiated at the next scheduled dose of amlodipine.
- Effectiveness of amlodipine in the control of 24-hour blood pressure in mild-to-moderate essential hypertension: a prospective, multicenter, observational real-world study from India, Cureus (2023)
- 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines, Circulation (2022)
- Peripheral edema and headache associated with amlodipine treatment: a meta-analysis of randomized, placebo-controlled trials, Journal of Hypertension (2019)
- Titration of amlodipine to higher doses: a comparison of Asian and Western experience, Vascular Health and Risk Management (2013)
- Uptitrating amlodipine significantly reduces blood pressure in diabetic patients with hypertension: a retrospective, pooled analysis, DovePress Taylor & Francis Group (2014)