Norvasc (Amlodipine) 2.5 mg / 5 mg / 10 mg Tablets: Prescription Long-Acting Dihydropyridine Calcium Channel Blocker for Hypertension, Stable Angina, and Coronary Artery Disease — Once-Daily, No OTC Version

Information last reviewed: May 2026 — for educational purposes only.

Amlodipine is a dihydropyridine (DHP) calcium channel blocker marketed under the brand name Norvasc. It is one of the most widely prescribed antihypertensive medications in the world, valued for its very long half-life of 35–50 hours, which enables reliable once-daily dosing with smooth, consistent 24-hour blood pressure coverage and minimal peak-to-trough variation. Missing an occasional dose rarely causes abrupt blood pressure changes.

Uses of Amlodipine

Amlodipine is approved for hypertension and for chronic stable angina and vasospastic (Prinzmetal) angina. It is a first-line agent for hypertension across most major guidelines. Several important combination products incorporate amlodipine: Exforge (amlodipine + valsartan), Caduet (amlodipine + atorvastatin — combining blood pressure and cholesterol management in a single tablet), and Azor (amlodipine + olmesartan). These fixed-dose combinations are useful for patients requiring polypharmacy to simplify their regimens and improve adherence.

Mechanism, Warnings, and Key Interactions

Amlodipine blocks voltage-gated L-type calcium channels primarily in vascular smooth muscle, causing arterial vasodilation. Unlike non-DHP CCBs such as diltiazem and verapamil, amlodipine has minimal negative chronotropic or inotropic effects on the heart — it does not significantly lower heart rate and does not reduce cardiac contractility at therapeutic doses. This makes it safe to use in heart failure, unlike diltiazem and verapamil which are contraindicated in HFrEF. The most common side effect is peripheral oedema (ankle and leg swelling), affecting approximately 10% of patients at the 10 mg dose. This oedema results from pre-capillary vasodilation — not from fluid retention — and consequently does not respond to diuretics. Combining amlodipine with an ACE inhibitor or ARB may reduce this oedema. Amlodipine limits simvastatin to 20 mg per day due to CYP3A4 inhibition (less potent than diltiazem's restriction of 10 mg/day). Other reported adverse effects include flushing, headache, dizziness, and rarely gingival hyperplasia.

Available Strengths and Dosing

Amlodipine tablets are available in 2.5 mg, 5 mg, and 10 mg strengths, taken once daily. The usual starting dose for hypertension is 5 mg once daily, which may be increased to 10 mg after 7–14 days if needed. The 2.5 mg dose is used in elderly patients, those with hepatic impairment, or as the initial dose in children aged 6–17 years. Due to its extremely long half-life, the full antihypertensive effect may take 7–14 days to become apparent after a dose change.

Pricing Overview

Generic amlodipine is one of the most cost-effective antihypertensives available, frequently found on $4–$10 monthly generic formularies at major pharmacies. Norvasc branded tablets are more expensive. Combination products (Caduet, Exforge, Azor) are priced higher but offer the adherence advantage of reducing pill burden. Contact Lucas Clinic for current pricing and product options.

Frequently Asked Questions

Why does amlodipine cause leg swelling, and can it be treated with diuretics?

The ankle and leg oedema caused by amlodipine is a pharmacodynamic effect of its vasodilatory mechanism — pre-capillary dilation increases capillary hydrostatic pressure, pushing fluid into interstitial tissue. Because it is not caused by sodium and water retention, diuretics are generally ineffective at resolving it. The most effective approach is dose reduction or switching to a different antihypertensive class. An alternative that sometimes helps is adding an ACE inhibitor or ARB, which causes efferent arteriolar dilation that partially counteracts the increased capillary pressure.

Is amlodipine safe in patients with heart failure?

Yes. Unlike the non-dihydropyridine CCBs diltiazem and verapamil, which reduce cardiac contractility and are contraindicated in HFrEF, amlodipine acts almost exclusively on vascular smooth muscle. Clinical trials (including PRAISE-2) found no significant increase in mortality or morbidity when amlodipine was used in patients with HFrEF. It is considered safe for managing hypertension or angina in patients who also have heart failure, making it a useful option in this complex population.

What is Caduet and when is it used?

Caduet is a fixed-dose combination tablet containing amlodipine (for blood pressure and angina) and atorvastatin (for cholesterol management). It is available in multiple strength combinations, such as amlodipine 5 mg/atorvastatin 10 mg through to amlodipine 10 mg/atorvastatin 80 mg. Caduet is indicated for patients who require both antihypertensive and lipid-lowering therapy, simplifying the regimen from two pills to one and potentially improving long-term adherence in patients managing cardiovascular risk factors simultaneously.

← Back to Blood Pressure Medications