Educational use only. Drug cards are AI-assisted study material for NCLEX preparation.
Mechanism of action
Blocks L-type calcium channels in vascular smooth muscle, causing arterial vasodilation. Selective for the vasculature, so it lowers BP and relieves anginal demand without much effect on heart rate or contractility. Used for hypertension and chronic stable angina.
Adverse effects
Life-threatening / NCLEX-tested
- Severe hypotension
- Reflex tachycardia (less than with short-acting CCBs)
- Worsening of pre-existing heart failure in some patients
- Hepatotoxicity (rare)
- Severe peripheral edema not always responsive to diuretics
Side effects
Common — what to teach
- Peripheral edema, especially ankle swelling — dose-dependent and very common
- Headache
- Flushing
- Dizziness, lightheadedness
- Gingival hyperplasia (rare; oral hygiene matters)
- Fatigue
Food & drug interactions
Grapefruit juice raises serum levels — counsel patients to avoid. Simvastatin dose should be capped at 20 mg with amlodipine (myopathy risk). NSAIDs blunt the antihypertensive effect. CYP3A4 inhibitors (clarithromycin, ketoconazole) raise levels. Combination with beta blockers is common and well-tolerated for angina or HTN — unlike non-dihydropyridines.
Nursing implications
Assessment, monitoring, patient teaching
- Check BP and pulse before each dose; expect minimal HR change unlike diltiazem/verapamil
- Teach patients to avoid grapefruit and grapefruit juice
- Reassure that ankle edema is benign and usually emerges in the first month — diuretics rarely fix CCB-induced edema; dose reduction or switch is the answer
- Encourage good oral hygiene to limit gingival hyperplasia
- Take at the same time each day; missed doses can be taken when remembered unless near the next dose
- Effect builds over days — full BP response takes 1–2 weeks
When to hold / contraindications
- SBP < 90 mmHg or symptomatic hypotension
- Severe aortic stenosis
- Acute decompensated heart failure
- Recent MI with hemodynamic instability
- Significant hepatic dysfunction (use lower doses)
Memory anchor
Dihydropyridine CCBs end in "-dipine" — "vessel-selective": they dilate, give edema, but don't drop heart rate. Reach for amlodipine when you need vasodilation without bradycardia.
Practice Amlodipine questions
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