Amlodipine

Legal status and availability in the UK

Amlodipine is a prescription-only medicine (POM) in the UK.

In our online pharmacy, amlodipine is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.

Basic amlodipine information

• INN (international nonproprietary name): Amlodipine.
• Brand names available in the United Kingdom: Istin; Norvasc; generic amlodipine besilate
• ATC code: C08CA01
• Forms and dosages: Tablets 2.5 mg, 5 mg, 10 mg; oral solution 1 mg/mL (limited); fixed-dose combinations with other agents exist
• Manufacturers in the United Kingdom: Pfizer, Accord, Sandoz and other generic manufacturers
• Registration status in the United Kingdom: Licensed by the MHRA
• OTC / Rx classification: Prescription-only medicine (POM)

Brands and pack sizes

In the UK, amlodipine is supplied under the brands Istin and Norvasc and as generic amlodipine besilate, commonly as 5 mg or 10 mg tablets in blister packs.

Who is amlodipine for? Indications and patient selection

Hypertension, angina, children and elderly

Which conditions is amlodipine licensed to treat?

Amlodipine is licensed for essential hypertension and for chronic stable or vasospastic angina.

The ATC classification is C08CA01, placing amlodipine among dihydropyridine calcium channel blockers.

For hypertension it is used as first‑line monotherapy in many patients or added to other classes when blood pressure remains uncontrolled.

For angina it reduces the frequency of attacks and improves exercise tolerance when used long term.

In children aged 6–17 years lower doses (commonly 2.5–5mg once daily) are used when a clinician approves treatment.

Amlodipine is not routinely recommended for children under 6 years.

In older adults start at lower doses and titrate slowly because of increased risk of hypotension and falls.

When to refer to GP or cardiology

Refer the patient urgently for medical review if they develop symptomatic hypotension such as fainting or persistent dizziness.

Refer if chest pain changes in pattern, intensity or frequency despite treatment.

Refer if severe peripheral oedema or angioedema occurs or if there are signs of heart failure worsening after initiation.

Points to check before starting

• Confirm recent blood pressure reading and target range with patient or prescriber.
• Check current medicines for antihypertensives and interacting drugs.
• Ask about pregnancy or breastfeeding status and contraception use.
• Confirm age—ensure paediatric dosing only if prescribed for 6–17 years.
• Review history of liver disease, heart failure or aortic stenosis.

Product forms, strengths and packaging

Tablets, oral solutions, fixed-dose combinations

What product forms will patients encounter at pharmacies?

Tablets are the most common dosage form, typically supplied as 2.5mg, 5mg and 10mg strengths.

Blister packs commonly contain 10, 28, 30, 56 or 100 tablets depending on the brand.

An oral solution of 1mg/ml exists but is limited to paediatric or special clinical circumstances.

Fixed‑dose combinations are widely available, for example amlodipine combined with valsartan, perindopril or atorvastatin.

Co‑formulations can simplify therapy and improve adherence by reducing pill burden when clinical indication fits.

In the UK brands commonly dispensed include Istin, Norvasc and generic amlodipine besilate, and tablets are usually dispensed in the original blister pack to maintain stability.

How to take amlodipine — administration, missed dose, overdose

Practical dosing tips and emergency actions

How should patients take amlodipine for best effect and safety?

Amlodipine is taken once daily and may be taken with or without food.

Swallow tablets whole and try to take them at the same time each day to aid adherence.

Typical adult starting dose for hypertension or angina is 5mg once daily with maintenance dosing 5–10mg once daily as needed.

Elderly patients and those with hepatic impairment should start at lower doses such as 2.5mg or 5mg and be titrated slowly.

Children aged 6–17 years typically receive 2.5–5mg once daily when prescribed by a specialist or paediatrician.

If a dose is missed take it as soon as it is remembered unless the next dose is due soon, in which case skip the missed dose and do not double up.

Overdose can cause severe hypotension and reflex tachycardia and requires immediate medical attention.

Emergency management includes cardiovascular support and decontamination measures as indicated by clinicians.

Counselling points

• Advise patients to monitor blood pressure regularly after starting or changing dose.
• Recommend avoiding sudden standing; rising slowly helps reduce dizziness.
• Record and report side effects such as significant swelling or fainting to the prescriber.

Safety profile and managing common adverse effects

What to expect, when to act

What are the common side effects and how should they be managed?

Common, dose‑related adverse effects include peripheral oedema, headache, flushing, dizziness, palpitations, fatigue and nausea or abdominal pain.

These effects often appear early in treatment and may reduce over several weeks as the body adjusts.

Practical measures for oedema include reducing sodium intake, elevating legs when seated and monitoring weight for progression.

For dizziness and hypotension advise patients to stand up slowly and to report falls or recurrent lightheadedness to the prescriber.

Persistent or troublesome oedema may require dose reduction or switching to a different agent within the class after prescriber discussion.

Red flags requiring urgent care include severe swelling with breathing difficulty, signs of angioedema, marked hypotension or worsening chest pain.

Report suspected adverse drug reactions through the Yellow Card Scheme to support pharmacovigilance.

Contraindications and special monitoring requirements

Absolute and relative contraindications; pregnancy/lactation

Who must not take amlodipine?

Absolute contraindications include hypersensitivity to amlodipine or other dihydropyridines, severe hypotension, shock including cardiogenic shock, and obstruction of left ventricular outflow such as severe aortic stenosis.

Amlodipine should not be used in patients with haemodynamically unstable heart failure post‑acute myocardial infarction.

Relative contraindications needing careful monitoring include severe hepatic impairment, severe heart failure and frailty in the elderly.

Pregnancy and breastfeeding require specialist assessment; use only if the expected benefit outweighs potential risk.

Action points

• Aortic stenosis → Do not supply; advise urgent prescriber review and cardiology referral.
• Pregnancy → Advise prescriber/obstetric team involvement and document discussion.
• Severe liver disease → Start at low dose and monitor liver function closely where directed.
• Severe hypotension or shock → Do not supply and seek emergency care.

Do not initiate amlodipine without prescriber oversight in scenarios of absolute contraindication.

Drug interactions and co-prescribing considerations

Major interactions, CYP considerations and statins

What medicines need caution when co‑prescribed with amlodipine?

Amlodipine has additive blood pressure lowering effects when combined with other antihypertensives such as ACE inhibitors, ARBs and beta‑blockers, so monitor for hypotension.

Concomitant use with simvastatin can increase exposure to simvastatin, and UK guidance often recommends limiting the simvastatin dose when co‑prescribed.

Amlodipine is metabolised in part by CYP3A4, so strong inhibitors or inducers of this enzyme may affect plasma levels.

Grapefruit juice may increase exposure to many calcium channel blockers and should be discussed with patients.

Switching therapy

When switching away from amlodipine follow prescriber guidance on titration and allow for overlap or washout depending on the alternative agent.

Ensure follow‑up blood pressure checks after any change in therapy.

Dose adjustments and use in special populations

Hepatic disease, renal impairment, elderly and children

How should dosing be adjusted for different patient groups?

Start elderly patients at the lowest effective dose, often 2.5mg or 5mg, and titrate slowly while monitoring blood pressure and falls risk.

Renal impairment generally does not require initial dose adjustment, but close monitoring of blood pressure and adverse effects is recommended.

Amlodipine is substantially metabolised by the liver so patients with hepatic impairment should start at lower doses and be titrated cautiously.

Children aged 6–17 years commonly receive 2.5–5mg once daily when prescribed by paediatric specialists; not recommended under age 6 years.

Alternatives and when to switch

Other CCBs and class comparisons

Which alternatives may be considered if amlodipine is unsuitable?

Other dihydropyridine calcium channel blockers include lercanidipine, felodipine, nifedipine and nicardipine.

Non‑CCB alternatives include ACE inhibitors, ARBs and beta‑blockers depending on comorbidity and patient profile.

Amlodipine’s once‑daily dosing and long half‑life support adherence compared with short‑acting nifedipine preparations.

Lercanidipine may be better tolerated for oedema in some patients, prompting a prescriber to switch class or agent.

Common reasons to switch include intolerable peripheral oedema, inadequate blood pressure response, drug interactions or supply issues.

Steps when considering a switch

1. Assess the symptom severity and timing relative to starting amlodipine.
2. Review concurrent medications and rule out drug interactions or additive hypotension.
3. Contact the prescriber with findings and suggest alternative agents if appropriate.
4. Arrange follow‑up BP checks after any change in therapy within 1–4 weeks.

Fixed-dose combinations and adherence benefits

Common combos, switching and prescribing notes

What fixed‑dose combinations containing amlodipine are commonly available?

Frequent combinations include amlodipine with valsartan, amlodipine with perindopril and combinations with atorvastatin for patients needing lipid‑lowering therapy alongside BP control.

Single‑pill combinations reduce pill burden and can improve adherence when both components are clinically indicated.

When switching to a fixed‑dose combination check that component strengths match the patient’s current regimen, as dose flexibility is reduced.

Counsel patients on the possible side effects of each active component and inform the prescriber if baseline monitoring is required.

Checklist when switching to a fixed-dose combination:

• Confirm the indication and current component doses match the FDC.
• Arrange baseline blood tests if an ACE inhibitor or ARB is included.
• Provide clear counselling about each active ingredient’s adverse effects.

Storage and packaging

Stability and storage advice

How should amlodipine be stored and checked?

Store amlodipine below 25°C and protect it from moisture and light.

Keep tablets in their original blister packaging until use to preserve stability.

On receipt, check the batch number, expiry date, blister integrity and the presence of the patient information leaflet.

Suspect packs should be set aside and reported to the MHRA with batch details.

• Check the blister seal, leaflet and expiry date.
• Do not use if blister is damaged or if tablets appear discoloured; contact the pharmacy for advice.

Frequently asked questions

• Can I take amlodipine with food? Yes, it may be taken with or without food.
• What happens if I miss a dose? Take as soon as remembered unless the next dose is due soon; do not double up.
• Can I switch brands? Yes, but expect tablet appearance to change and report any new side effects to your prescriber.
• Is amlodipine safe in pregnancy? Discuss with your prescriber; use only if benefit justifies risk.
• How soon does blood pressure fall? Some effect may be seen within days, with maximal effect over several weeks.

Delivery across the United Kingdom