Who Should Take Amlodipine?

Amlodipine is recommended as a first-line treatment for hypertension, particularly in people over 55 and in Black and African-Caribbean patients, where ACE inhibitors are often less effective. It's also used for stable angina.

Dose	Use
5 mg once daily	Starting dose for hypertension
10 mg once daily	Maximum dose: if 5 mg insufficient
5–10 mg once daily	Stable angina (chest pain prevention)

Common Side Effects

Ankle/leg swelling (oedema): affects up to 20% of patients
Facial flushing (warmth, redness)
Headache
Palpitations
Dizziness on standing (postural hypotension)
Rarely: gum overgrowth (gingival hyperplasia)

Ankle Swelling TipAmlodipine-related ankle swelling is not dangerous (it's not caused by heart or kidney problems: it's due to local blood pooling). Elevating your legs and adding an ACE inhibitor can reduce this. Don't stop amlodipine without talking to your doctor.

Drug Interactions

Drug	Interaction
Simvastatin	Amlodipine raises simvastatin levels: use ≤20 mg simvastatin
Ciclosporin	Amlodipine significantly raises ciclosporin levels
Clarithromycin	Increases amlodipine blood pressure-lowering effect
St John's Wort	Reduces amlodipine effectiveness

Can I take amlodipine and lisinopril together?

Yes. This is one of the most common and effective blood pressure combinations. The ACE inhibitor also helps reduce amlodipine-related ankle swelling.

Does amlodipine affect heart rate?

Unlike beta-blockers, amlodipine does not significantly slow the heart rate. It's preferred when a patient has asthma or cold extremities.

Should I take amlodipine in the morning or evening?

Either: amlodipine has a 35–50 hour half-life, so timing is less critical than for short-acting drugs. Morning is most common.

Ankle swelling, and why it is not fluid overload

Ankle swelling is the most common reason people stop amlodipine, and the mechanism is frequently misunderstood. Amlodipine dilates arterioles more than venules, raising pressure in the capillary bed and pushing fluid into the tissues locally. It is not fluid retention from the heart or kidneys, which is why diuretics work poorly for it and add unnecessary risk. The swelling is dose-related, worse in hot weather and after prolonged standing, and more common in women.

Practical responses are reducing the dose, switching to another agent, or adding an ACE inhibitor or ARB, which dilates the venous side and often relieves the swelling while improving blood pressure control. Elevating the legs helps modestly. If swelling is sudden, one-sided, painful or accompanied by breathlessness, it is not the amlodipine and needs assessment.

What monitoring amlodipine does and does not need

Unlike ACE inhibitors, ARBs and diuretics, amlodipine does not require routine kidney function or electrolyte monitoring, because it does not affect potassium or renal perfusion in the same way. What it does require is blood pressure review after starting or changing dose, since the full effect takes around two weeks to establish. This makes it a convenient option in chronic kidney disease, where other agents need closer laboratory follow-up.

Interactions worth knowing

Simvastatin: the dose is capped at 20 mg daily with amlodipine because of an increased risk of muscle toxicity.
Grapefruit juice raises amlodipine levels modestly by inhibiting its metabolism.
Clarithromycin and some antifungals increase levels and can cause pronounced hypotension.
Sildenafil and related drugs add to the blood-pressure-lowering effect; the combination is not prohibited but warrants caution.

Taking it, and what to do about a missed dose

Amlodipine has a long half-life, so it is taken once daily at any consistent time and a single missed dose has little effect on control. Take it when remembered unless the next dose is nearly due, and do not double up. Do not stop it abruptly without discussing alternatives; unlike beta blockers there is no rebound tachycardia, but blood pressure will simply return to its untreated level, and uncontrolled hypertension is symptomless until it causes harm.

References

The clinical information on this page is drawn from peer-reviewed sources indexed by the US National Library of Medicine. Links go to the source so you can read it yourself.

Amlodipine. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK519508
Antihypertensive Medications. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK554579

Amlodipine: Blood Pressure Medication Guide