Amlodipine
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Trade Name
Norvasc (primary brand name); generic amlodipine besylate
Classification
Calcium channel blocker (CCB); dihydropyridine type; antihypertensive, antianginal
Dosage/Route
- * Dosage: Tablets: 2.5 mg, 5 mg, 10 mg
- * Route: Oral (PO)
Usual Dosage
- * Hypertension: Start 5 mg PO once daily; max 10 mg/day
- * Angina: 5-10 mg PO once daily
- * Elderly/Children (6-17): Start 2.5 mg PO daily; max 5 mg/day
- * Adjust based on BP response; titrate over 7-14 days
Mechanism of Action
Inhibits calcium influx into vascular smooth muscle and cardiac cells via L-type calcium channels, causing vasodilation (primarily arterial). Reduces peripheral resistance (lowers BP) and coronary artery spasm (relieves angina), with minimal effect on heart rate
Side Effects & Adverse Effects
- * Side Effects: Peripheral edema, headache, dizziness, flushing
- * Adverse Effects:
- – Severe hypotension (rare; esp. with overdose)
- – Worsened angina/MI (rare, abrupt stop or high dose)
- – Gingival hyperplasia (long-term, uncommon)
- – Reflex tachycardia (mild, less than other CCBs)
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor BP, HR baseline and after dose changes (orthostasis risk)
- – Assess for edema (ankles, feet) and chest pain (angina worsening)
- – Check liver function in hepatic impairment (longer half-life)
- – Avoid grapefruit juice (increases drug levels)
- * Teachings:
- – Take same time daily, with/without food
- – Report swelling, dizziness, or chest pain
- – Elevate legs if edema occurs; don’t stop abruptly
- – Maintain dental hygiene (gingival hyperplasia risk)
Indication for This Patient
- * Hypertension (alone or with other agents)
- * Chronic stable angina or vasospastic (Prinzmetal’s) angina (reduces chest pain)
Time
- * Timing: Once daily (any time, but consistent)
- * Onset: 30-60 minutes
- * Peak: 6-12 hours
- * Duration: 24 hours (long half-life ~30-50 hours)
