Norvasc

Norvasc (amlodipine besylate) is a widely prescribed calcium channel blocker indicated for the management of hypertension and chronic stable angina. As a first-line antihypertensive agent, it functions by relaxing blood vessels, thereby improving blood flow and reducing cardiac workload. Its long half-life supports consistent 24-hour efficacy with once-daily dosing, making it a cornerstone therapy in cardiovascular medicine. Clinicians favor Norvasc for its predictable pharmacokinetics and favorable safety profile across diverse patient populations.

Features

• Active ingredient: Amlodipine besylate
• Available in 2.5 mg, 5 mg, and 10 mg oral tablets
• Belongs to the dihydropyridine calcium channel blocker class
• Long elimination half-life (~30–50 hours)
• Once-daily dosing regimen
• FDA-approved for hypertension and angina

Benefits

• Effectively lowers systolic and diastolic blood pressure
• Reduces frequency of angina episodes and need for nitroglycerin
• Provides smooth 24-hour hemodynamic control without peak-trough fluctuations
• Demonstrates minimal effect on heart rate and cardiac conduction
• Suitable for use in patients with asthma, diabetes, and gout
• Compatible with many other antihypertensive agents for combination therapy

Common use

Norvasc is primarily prescribed for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive drugs. It is also indicated for the management of chronic stable angina and confirmed or suspected vasospastic angina. Off-label uses may include Raynaud’s phenomenon and certain cases of heart failure with preserved ejection fraction, though these applications require careful clinical evaluation.

Dosage and direction

The recommended initial dose for hypertension is 5 mg once daily, which may be increased to a maximum dose of 10 mg daily based on therapeutic response. For angina, starting doses typically range from 5–10 mg daily. Dosage adjustments are necessary in patients with hepatic impairment or elderly patients—often initiating at 2.5 mg daily. Administration may occur with or without food, preferably at the same time each day to maintain steady plasma concentrations. Tablets should be swallowed whole and not crushed or chewed.

Precautions

• Regular blood pressure monitoring is essential during therapy initiation and titration
• Use caution in patients with severe aortic stenosis due to risk of reduced coronary perfusion
• May cause peripheral edema, which is dose-dependent and more common at higher doses
• Hepatic impairment requires dosage reduction and careful monitoring
• Not recommended during pregnancy unless potential benefit justifies potential risk
• Elderly patients may exhibit increased sensitivity and require lower starting doses

Contraindications

• Known hypersensitivity to amlodipine or any component of the formulation
• Patients with cardiogenic shock
• Significant hypotension (systolic BP <90 mmHg)
• Concurrent use with strong CYP3A4 inhibitors in patients with hepatic impairment

Possible side effects

• Peripheral edema (dose-related)
• Headache
• Dizziness
• Flushing
• Palpitations
• Fatigue
• Nausea
• Abdominal pain
• Somnolence
• Rare cases of gingival hyperplasia

Drug interaction

• Moderate to strong CYP3A4 inhibitors (ketoconazole, itraconazole) may increase amlodipine concentrations
• Simvastatin coadministration may increase simvastatin exposure
• Enhanced hypotensive effects with other antihypertensive agents
• Calcium supplements may reduce effectiveness
• Use cautiously with cyclosporine due to potential increased cyclosporine levels

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration.

Overdose

Symptoms may include profound hypotension and reflex tachycardia. Management involves cardiovascular monitoring and supportive care, including elevation of extremities and administration of vasopressors if necessary. Calcium gluconate administration may be considered. Due to high protein binding, dialysis is not likely to be beneficial.

Storage

Store at controlled room temperature (20–25°C or 68–77°F). Protect from light and moisture. Keep in the original container with the lid tightly closed. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Norvasc is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual response to therapy may vary. Always consult with a healthcare professional before starting or changing any medication regimen.

Reviews

Clinical studies demonstrate Norvasc’s efficacy in reducing blood pressure by 10–15 mmHg systolic and 5–10 mmHg diastolic in hypertensive patients. Angina patients show approximately 40% reduction in nitroglycerin consumption and significant improvement in exercise tolerance. Long-term extension studies confirm maintained efficacy over 52 weeks of treatment with consistent safety profile. Real-world evidence supports these findings, with particular note of its tolerability in elderly populations.