Amlodipine is a calcium channel-blocking agent further classified in the group named as Dihydropyridines. Amlodipine has a longer action as compared to other calcium channel blockers and is available as Amlodipine besylate, Amlodipine maleate or Amlodipine mesylate. Other drugs included in this group are Aranidipine, Azelnidipine, Felopdipine, Isradipine, Efonidipine, Lacidipine, Nicardipine, Nifedipine, Nimodipine, Nisoldipine, Pranidipine and Nitrendipine.
The basic mechanism of action of this drug depends on blocking on calcium channels in the walls of smooth muscle of the vessels specifically and rest of the body organs generally. Once the calcium channels are blocked, influx of calcium does not take place (calcium influx is mainly responsible for the contraction of smooth muscles. Resultantly, the smooth muscle of the vascular wall is relaxed causing vasodilation of the blood vessels. In this way it exerts many positive effects in the management of cardiovascular problems in the body. Amlodipine is marketed all over the world with the certain brand or trade names like Norvasc, Amlovas, Nopidin etc.
What is Amlodipine used for?
Common uses of Amlodipine are:
- Hypertension – Amlodipine is very effective in the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents. It causes vasodilation of the arteries and thus decreases the arterial pressure. Moreover, the load on the heart is also reduced. In this way Amlodipine prevents the incidence of stroke, myocardial infarction and renal failures occurring due to chronic hypertension.
- Coronary artery disease – Amlodipine has shown promising results in the management of central chest pain due to coronary ischemia. Both the types of angina: stable and prinzmetal (vasospastic) angina can be treated by this drug can be used alone or in combination with other anti anginals. It increases the blood supply to the heart and thus fulfills the oxygen demand.
- It is also used for the coronary artery disease already diagnosed with coronary angiography. It has no role in the management of acute myocardial infarction for which sublingual nitroglycerine is more effective and is used commonly.
What are the common side effects of Amlodipine?
Amlodipine is a safe drug among other calcium channel blocking agents. Few of the side effects of Amlodipine are:
- Swelling of extremities – peripheral edema is one of the striking features in hypertensive patients using Amlodipine for long time. Sometimes, this pedal edema (swelling of feet) is confused with heart failure. So, it is always better to rule out the possibility of Amlodipine use before making any impression.
- Tiredness – studies have shown that in almost four to five percent of the individuals on Amlodipine experience extreme fatigue and tiredness almost the whole day
- Gastrointestinal disorders – nausea, vomiting, stomach pains and cramps, and dyspepsia are common gastrointestinal side effects of Amlodipine. In addition to constipation it may also cause diarrhea. Drug induced pancreatitis also occurs rarely.
- Cardiovascular problems- during Amlodipine use patient can experience increased heart rate (tachycardia) and palpitations (feeling of heart beat). Moreover, Amlodipine use is contraindicated in conditions like unstable angina, aortic stenosis and cardiogenic shock. Amlodipine also causes orthostatic hypotension
- Dizziness – one must not be allowed to drive or handle machines during the use of Amlodipine
- Breast development (Gynecomastia)
- Sexual dysfunction and impotence
- Sleep disorders – chronic Amlodipine use may cause insomnia
- Psychiatric disorders – mood swings are common with the use of Amlodipine. It may even lead to permanent depression. Moreover, the behavior of an individual may be altered, unpredictable or erratic
- Enlargement of the gums (Gingival enlargement)- it is another common side effect of Amlodipine which comes only with chronic use.
- Liver problems – it may cause mild drug induced hepatitis and jaundice
- Bleeding disorders – bleeding tendency is increased with chronic use of Amlodipine. It causes thrombocytopenia that may result in purpurae all over the body.
- Flushing – due to its vasodilator effect, Amlodipine cause flushing of face and there is feeling of warmth all over the body.
- Allergic reactions – like any other drug, Amlodipine can cause different types of allergic reactions manifested as rash, swelling and bronchospasm
- Weight changes – it can either cause weight loss or weight gain, but this effect is not very common.
What are the side effects of Amlodipine on children?
Although almost all the side effects of Amlodipine may occur in the children, however, few side effects like peripheral edema, abdominal discomfort, tiredness, giddiness and tachycardia occur more frequently in children than in adults.
What are the side effects of Amlodipine on men?
In men, the most common side effects of Amlodipine are:
- Gynecomastia – abnormally large breast development is seen in men during the use of this drug. This side effect is gone once the drug use is discontinued.
- Impotence – decreased libido and impotency are other common adverse effects observed during the use of this drug.
What are the side effects of Amlodipine on women?
A clinical trial showed that following adverse effects of Amlodipine were more in women as compared to men:
- Peripheral edema and swelling
- Flushing of the skin
- Irregular heart rate and palpitations
- Fatigue and tiredness
What are the side effects of Amlodipine on pregnant women?
Amlodipine is classified as category C drug in during pregnancy. Animal studies show that use of Amlodipine during pregnancy increases the rate of intrauterine deaths. Moreover, it may cause prolonged labor or miscarriages if used early in the pregnancy. It is also contraindicated for the nursing mothers because of adverse effects it can have on the breastfed baby.
What are the side effects of Amlodipine on elderly?
The most common and dangerous side effect of Amlodipine in the elderly is unusual and abrupt falls and fainting. It occurs due to the vasodilatory effect of Amlodipine causing a marked decrease in blood pressure when the patient stands. This phenomenon is known as orthostatic hypotension. As the blood pressure falls, it causes blackout and fainting attacks in the elderly. Moreover, dizziness, light headedness and lack of energy are other common side effects of Amlodipine in the elderly.