What to Know About Norvasc (Amlodipine)

Norvasc (amlodipine) is a prescription medication used most often to treat hypertension (high blood pressure). It is prescribed either as a standalone medication or in combination with other therapies. It can also be used to treat stable angina (chest pain).

Norvasc belongs to a class of medications called calcium channel blockers that work by affecting the amount of calcium that enters the cell. Calcium causes more forceful contraction of the heart and arteries; blocking the entry of calcium into these cells can help them to relax, thereby lowering blood pressure.

Besides being sold as Norvasc, in the United States amlodipine is sold under the brand name Katerzia as well as generically. It is available in pill or liquid forms.

Uses

There are three uses for Norvasc approved by the Food and Drug Administration (FDA). It may be used to treat:

• Hypertension (ages 6 and older)
• Chronic stable angina (chest pain)
• Vasospastic angina (chest pain)

Off-Label Uses

Although not approved by the FDA for this use, Norvasc is sometimes prescribed to treat Raynaud's phenomenon.

Before Taking

Before your healthcare provider prescribes Norvasc for you, you will have been diagnosed with hypertension severe enough to require medication. They will go over your medical history, current health problems, allergies, and other medications or supplements you may be taking. They also will assess your cardiac health with a physical exam, by taking your vital signs, and possibly with an electrocardiogram or echocardiogram.

[Standard disclaimer: Talk to your healthcare provider about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.]

Precautions and Contraindications

Before taking this or any medication, review the precautions and contraindications with your healthcare provider to be sure you don’t have any conditions that might prevent this medication from being right for you.

Norvasc should not be taken by anyone who has a hypersensitivity to it or any component of it. Make sure you healthcare provider is aware if you have or have had:

• Chest pain
• A heart attack
• Low blood pressure (hypotension)
• Swelling in your hands or feet (peripheral edema)
• Aortic stenosis
• Heart failure
• Hypertrophic cardiomyopathy
• Liver disease (individuals who have liver disease may be able to take Norvasc but must do so in individualized dosages)

Norvasc should be used with caution during pregnancy, as there is some evidence it could have an adverse effect on a developing baby. There is currently inadequate human data available to thoroughly assess risk. Amlodipine should only be used in pregnancy if the benefits outweigh the risks.

Norvasc crosses the placenta and is present in breastmilk. Caution is advised while breastfeeding.  There is only limited human data that suggest no known risk of infant harm.

Tell your healthcare provider if you're pregnant or nursing before you begin taking Norvasc (or any new medication).

Other Calcium Channel Blockers

If it turns out Norvasc (or another form of amlodipine) doesn't work for you, there are other medications in the same class for treating high blood pressure:

• Diltiazem (Cardizem, Tiazac, others)
• Felodipine
• Isradipine
• Nicardipine
• Nifedipine (Adalat CC, Procardia)
• Nisoldipine (Sular)
• Verapamil (Calan, Verelan)

Dosage

How your healthcare provider prescribes Norvasc will depend on what you're being treated for. Standard dosages are based on specific conditions for adults.

• Hypertension: Initially 2.5 milligrams (mg) to 5 mg once daily, increased to 10 mg if necessary.
• Chronic stable angina or vasospastic angina: 5 mg to 10 mg once daily.
• Reynaud’s phenomenon: 5 mg once daily, increased once every four weeks as needed.

[All listed dosages are according to the drug manufacturer. Check your prescription and talk to your healthcare provider to make sure you are taking the right dose for you.] 

Modifications

For seniors and children, standard dosages also vary:

• Seniors with hypertension: 2.5 mg initially, once per day
• Seniors with angina: 5 mg initially, once per day
• Children under 6 with hypertension: 0.1 mg/kg/dose once daily, increased slowly, with a daily maximum dose of 0.6 mg/kg/dose
• Children over 6 with hypertension: 2.5 mg per day initially, increased slowly, with a daily maximum of 10 mg
• Children over age 6 with Reynaud’s phenomenon: 2.5 mg to 10 mg per day

Adult with liver disease also require special dosing—typically 2.5 mg initially for hypertension and 5 mg per day for angina.

How to Take and Store

It's important to carefully follow your healthcare provider's instructions for taking Norvasc and to keep other considerations in mind as well:

• This medication can be taken with or without food.
• Take Norvasc at the same time every day.
• If you miss a dose, take Norvasc as soon as you realize it, unless it's nearly time for the next dose, in which case skip the missed dose: do not take a double dose.
• Store Norvasc in its original container, away from moisture, heat, or direct light, and out of sight and reach of children.
• Do not stop taking this medication suddenly. Speak with your healthcare provider if you feel you need to quit taking Norvasc for any reason first.

Side Effects

As with all medications, Norvasc is associated with certain side effects.

Common

Tell your healthcare provider if while taking Norvasc you experience:

• Headache
• Dizziness
• Sweating
• Tender or bleeding gums
• Indigestion or upset stomach
• Stomach cramps

Severe

In the event you develop any of the following symptoms, call your healthcare provider immediately:

• Swelling in the ankles or feet
• Chest pain or tightness
• Black, tarry stools
• Blood in urine
• Blurred vision
• Confusion
• Enlarged neck veins
• Racing heart
• Hives or rash
• Yellow (jaundiced) eyes or skin

Warnings and Interactions

Norvasc is known to interact with both Crixivan (indinavir) and Priftin (rifapentine). If you take either of these, your healthcare provider may adjust your dosage of both or either drug for safety and effectiveness.

You should not take Norvasc if you take any of the following medications:

• Abametapir
• Bromperidol
• Conivaptan
• Pimozide
• Systemic fusidic acid

There are many medications that may interact with Norvasc but that do not necessarily preclude taking it. Your healthcare provider may monitor your closely and/or adjust your dose if you also take:

• Alfuzosin
• Alpha-1 blockers
• Amifostine
• Amphetamines
• Antifungal agents
• Antihepaciviral combination products
• Antipsychotic agents
• Aprepitant
• Atosiban
• Barbituates
• Benperidol
• Brigatinib
• Brimotidine
• Calcium channel blockers
• Calcium salts
• Carbamazepine
• Clofazimine
• Clopidopgrel
• Cyclosporine
• CYP3A4 inducers
• CYP3A4 inhibitors
• Dabrafenib
• Dapoxetine
• Deferasirox
• Dexamethylphenidate
• Diazoxide
• Dofetilde
• Duloxetine
• Duvelisib
• Efavirenz
• Enzalutamide
• Erdafitnib
• Flibanserin
• Fluconazole
• Fosaprepitant
• Fosnetupitant
• Fosphenytoin
• Idelaisib
• Ivosidenib
• Larotrectinib
• Lembroexant
• Levadopa-containing medications
• Lomitapide
• Lormetazepam
• Lovastatin
• Macrolide antibiotics
• Magnesium salts
• Melatonin
• Methylphenidate
• Mifepristone
• Mitotane
• Molsidomine
• Naftopidil
• Netupitant
• Neuromuscular-blocking agents
• Nicegoline
• Nicorandil
• Nimopidine
• Nitroprusside
• Obinutuzumab
• Palbociclib
• Pentoxifylline
• Phenytoin
• Pholcodine
• Phosphodiesterase
• Pimozide
• Prostacyclin analogues
• Quinagolide
• Quinidine
• Rifamycin
• Sarilumab
• Simaprevir
• Simvastatin
• Sincalide
• Stiripentol
• Tacrolimus
• Tocilizumab
• Ubrogepant
• Yohimbine