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 also can 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 Food and Drug Administration uses for Norvasc. It may be used to treat:

• Hypertension in people 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 doctor 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 an electrocardiogram or echocardiogram.

[Standard disclaimer: Talk to your doctor 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 doctor 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 doctor 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
• There are some people who can take Norvasc but in individualized dosages, specifically children, seniors, and individuals who have liver disease.

Norvasc crosses the placenta and is present in breastmilk, but women who are pregnant or breastfeeding can safely take it.Norvasc is a category C medication for pregnant women, meaning there is some evidence it could have an adverse effect on a developing baby, but the benefits of the medication to the mother may outweigh the risks.Tell your doctor 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 doctor prescribes Norvasc will depend on what you're being treated for. The standard dosages based specific conditions for adults are:

• Hypertension: Initially 2.5 milligrams (mg) to 5 mg once daily, increased every one to two weeks until desired response
• 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 doctor 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

In order to be as safe and effective as possible, it's important to carefully follow your doctor'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 doctor 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 doctor 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 these symptoms, call your doctor 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 Your doctor may adjust the dosage or frequency of Indinavir and Priftin (rifapentine). If you take either of these, your doctor will adjust your dosage for safety and effectiveness.

You should not take Norvasc if you take any of these medications:

• Abametapil
• Bromperidol
• Conivaptan
• Systemic fusidic acid

There are many medications that may interact with Norvasc but that do not necessarily preclude taking it. Your doctor 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