ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Dihydropyridine Calcium Channel Blocker Pregnancy: Avoid if possible — limited data; labetalol or nifedipine preferred in pregnancy hypertension

Amlodipine

Brand names: Istin

Adult dose

Dose: Hypertension/angina: 5 mg OD initially, increase to 10 mg OD after 2–4 weeks if needed
Route: Oral
Frequency: Once daily
Max: 10 mg OD
Long half-life (~40h) — once daily dosing. Gradual onset. No significant rebound effect on stopping. First-line antihypertensive per NICE NG136.

Paediatric dose

Dose: 0.05 mg/kg
Route: Oral
Frequency: Once daily
Max: 10 mg OD
Concentration: 1 mg/mL oral solution mg/ml
Children 2–17 years: 2.5 mg OD initially, titrate to 5 mg OD. Licensed for hypertension in children ≥6 years.

Dose adjustments

Renal

No dose adjustment required

Hepatic

Start at 2.5 mg OD in hepatic impairment; titrate cautiously

Paediatric weight-based calculator

Children 2–17 years: 2.5 mg OD initially, titrate to 5 mg OD. Licensed for hypertension in children ≥6 years.

Clinical pearls

  • ALLHAT and ASCOT-BPLA: amlodipine comparable or superior to other drug classes for CV outcomes
  • Oedema is due to arteriolar dilation (precapillary), not fluid retention — ACEi/ARB combination reduces oedema
  • NICE NG136: Step 1 hypertension in adults <55 years: ACEi/ARB. ≥55 years or Black African/Caribbean: CCB (amlodipine)
  • Not a negative inotrope — can be used in HFpEF and mild LV impairment (unlike verapamil/diltiazem)

Contraindications

  • Unstable angina (initiation not recommended)
  • Aortic stenosis (severe)
  • Cardiogenic shock

Side effects

  • Peripheral oedema (ankle/feet — most common, dose-related)
  • Flushing
  • Headache
  • Palpitations
  • Dizziness
  • Nausea
  • Gingival hyperplasia (rarely)

Interactions

  • Ciclosporin — increases ciclosporin levels
  • Tacrolimus — increases tacrolimus levels
  • Simvastatin — limit simvastatin to 20 mg/day (MHRA 2012 warning)
  • Strong CYP3A4 inhibitors — increase amlodipine exposure

Monitoring

  • Blood pressure (target <140/90 mmHg; <130/80 in high CV risk)
  • Peripheral oedema
  • Heart rate
  • ECG (rarely needed)

Reference: BNFc; BNF; NICE NG136 Hypertension in Adults; ALLHAT Trial (JAMA 2002); ASCOT-BPLA (Lancet 2005). Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Same class
Pathways
Same specialty