Ankle Swelling as a Side Effect of Norvasc (Amlodipine)

Why It Occurs and What You Can Do

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Norvasc (amlodipine besylate) is a type of medication known as a calcium channel blocker. This class of medication contains compounds that relax blood vessels and decrease blood pressure. This makes it easier for your heart to pump blood throughout the body.

As important as Norvasc is in treating hypertension (high blood pressure) and angina (heart-related chest pain), it can cause side effects. One of the most common is the swelling of the ankles caused by the accumulation of fluids in tissues.

A man rubbing his swollen ankle
Jan-Otto / Getty Images

This article explains why ankle swelling occurs in people who take Norvasc and what can be done to relieve this common but frustrating side effect.

Symptoms

Edema, or the abnormal swelling of tissues caused by the accumulation of fluids, is a common side effect of calcium channel blockers, especially Norvasc. It typically involves the ankles and feet due to gravity but can also affect the hands and lower legs.

The risk is largely dose-dependent, meaning that higher doses correspond to a greater likeliness (or the worsening) of symptoms.

Other side effects of Norvasc include headaches, lightheadedness, fainting spells, dizziness, an irregular heartbeat, chest pain, or palpitations.

Recap

Edema, the abnormal swelling of tissues due to fluid accumulation, is a common side effect of Norvasc. The ankles and feet are most commonly affected, but the hands and lower legs may also be involved.

Cause

Edema commonly occurs with calcium channel blockers because the drugs trigger the dilation of blood vessels. The dilation, in turn, lowers the blood pressure and improves the flow of blood throughout the body.

However, the improved blood flow can increase the pressure within smaller blood vessels called capillaries. This can cause fluids to seep through the walls of the vessels into surrounding tissues.

Edema can occur with all calcium channel blockers.

Recap

Norvasc helps lower blood pressure by triggering the dilation of blood vessels. The increased blood flow, in turn, intensifies the pressure within smaller blood vessels, causing excess fluids to seep through the walls of the vessels into surrounding tissues.

Treatment

If you experience edema while taking Norvasc, do not stop treatment until you speak with your healthcare provider. In some cases, you may be placed on a diuretic ("water pill") to reduce the swelling. Or, the Norvasc dose may be reduced.

If symptoms persist, your healthcare provider may switch you to another calcium channel blocker or another class of blood pressure medications.

It is important to note that ankle swelling is also a symptom of heart failure and pulmonary hypertension. As such, Norvasc may not be the cause of edema but simply contribute to its development. Your healthcare provider may want to perform additional tests to rule out these conditions before changing treatment.

Recap

If you experience edema while on Norvasc, your healthcare provider may opt to reduce the dose or change you to another calcium channel blocker or an entirely different class of blood pressure medication.

Recommended Dosage

Norvasc is available as a tablet and formulated in doses of 2.5, 5, and 10 milligrams (mg). The standard recommended dose is 5 mg once daily, increasing to a maximum dose is 10 mg once daily if needed.

People who are smaller, elderly, or have liver problems should be started on a 2.5-mg dose and increased gradually to obtain the desired response.

Never exceed the recommended daily dose. It is possible to overdose on calcium-channel blockers, leading to potentially serious side effects, such as:

  • Constipation
  • Confusion
  • Drowsiness
  • Slowed heartbeat
  • Slurred speech
  • Shortness of breath
  • Weakness
  • Nausea
  • Increased blood sugar

If an overdose is suspected, call the Poison Control Hotline at 1-800-222-1222, available 24 hours sevens days a week. Do not induce vomiting unless a trained poison control professional tells you to do so.

Recap

For most adults, the recommended dose of Norvasc is 5 mg once daily, increasing to a maximum dose is 10 mg once daily if needed. Do not exceed the recommended dose.

Summary

Norvasc (amlodipine besylate) is a type of drug called a calcium channel blocker used to treat high blood pressure and angina. One of the more common side effects of Norvasc is edema, or the abnormal swelling of tissue due to the build-up of fluid. Although the ankles and feet are most commonly affected, the hands and lower legs may also experience swelling.

Calcium channel blockers like Norvasc help lower blood pressure by dilating blood vessels. The increased blood flow, in turn, intensifies the pressure within smaller blood vessels, causing fluids to leak through the walls of the vessels into surrounding tissues.

If edema occurs while taking Norvasc, call your healthcare provider. You may be switch to another calcium channel blocker or a different class of blood pressure medication. Or, the Norvasc dose may simply be reduced to see if that helps. Never stop or alter treatment without first speaking to your healthcare provider.

A Word From Verywell

Edema can be a worrisome and frustrating side effect of Norvasc. But, on its own, edema is not a reason to stop treatment. Even if your healthcare provider cannot fully resolve the swelling, the benefits of medications like Norvasc generally outweigh the risks.

This doesn't mean, however, that you should ignore the side effect or "just live with it." By exercising regularly, eating a healthy diet, and maintaining your ideal weight, you may be able to minimize or alleviate the symptoms of edema caused by Norvasc.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bulsara KG, Cassagnol M. Amlodipine. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519508/

  2. Galappatthy P, Waniganayake YC, Sabeer MI, Wijethunga TJ, Galappatthy GK, Ekanayaka RA. Leg edema with (S)-amlodipine vs conventional amlodipine given in triple therapy for hypertension: a randomized double blind controlled clinical trialBMC Cardiovasc Disord. 2016;16(1):168. doi:10.1186/s12872-016-0350-z

  3. Makri OE, Georgalas I, Georgakopoulos CD. Drug-induced macular edema. Drugs. 2013;73(8):789-802.

  4. Morrison RT. Edema and principles of diuretic use. Med Clin North Am. 1997;81(3):689-704.

  5. Miyoshi K, Okura T, Nagao T, Masanori J, Irita J, Higaki J. Effects of dividing amlodipine daily doses on trough drug concentrations and blood pressure control over a 24-hour period. Clin Ther. 2013;35(9):1418-22.

Additional Reading
  • Calcium-Channel Blockers Overdose. Medline.

  • Cho S. "Peripheral edema."American Journal of Medicine. 113:580-586.

By Michael Bihari, MD
Michael Bihari, MD, is a board-certified pediatrician, health educator, and medical writer, and president emeritus of the Community Health Center of Cape Cod.