Drug updated on 4/17/2024
| Dosage Form | Tablet (oral: 2.5 mg, 5 mg, 10 mg) |
| Drug Class | Calcium channel blockers |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.
- For the treatment of coronary artery disease; chronic stable angina; vasospastic angina (prinzmetal's or variant angina); angiographically documented coronary artery disease in patients without heart failure or an ejection fraction < 40%.
Summary
- Amlodipine besylate (Norvasc) is used for the management of hypertension, coronary artery disease, chronic stable angina, and vasospastic angina. It significantly lowers blood pressure and reduces the risk of fatal and nonfatal cardiovascular events.
- Six systematic reviews/meta-analyses provided information on amlodipine's effectiveness in managing blood pressure when combined with perindopril or ARBs, its effectiveness in decreasing vasospastic angina compared to other calcium channel blockers like diltiazem and nifedipine, as well as its safety profile.
- The combination of amlodipine with ACE inhibitors or ARBs was shown to improve outcomes in managing hypertension while reducing peripheral edema more effectively than monotherapy or combinations with other dihydropyridine calcium channel blockers (DHPCCBs).
- Side effects such as peripheral edema and headache can limit the use of amlodipine, but these side effects vary based on dosage - lower/medium doses result in fewer instances compared to higher doses.
- Among DHPCCBs, amlodipine has a significant risk for causing peripheral edema but is less likely to do so than nifedipine. When used alongside renin-angiotensin system blockers, though, this risk substantially decreases.
- Specifically, in Asian populations dealing with hypertension, various combinations involving ARB-Amlodipine therapy showed better response rates compared to using Amlodipine alone. One particular combination that stood out was AZL-Amlodipine due to favorable treatment responses observed during trials.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Norvasc (amlodipine besylate) Prescribing Information. | 2019 | Pfizer Labs, Div of Pfizer Inc., NY |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Amlodipine in the current management of hypertension. | 2023 | The Journal of Clinical Hypertension |
| 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes: the task force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). | 2020 | European Heart Journal |