Amlodipine (norvasc) Side Effects
What Is Norvasc (Amlodipine)?
Norvasc is the brand name for amlodipine besylate, a prescription drug used to treat hypertension, or high blood pressure.
Norvasc is also used to treat coronary artery disease (CAD) in patients without heart failure, and certain types of angina (chest pain) from CAD, such as activity- and stress-induced angina (chronic stable angina), and angina that occurs at rest (Prinzmetal’s angina).
Taken regularly, Norvasc can control angina, but it doesn't stop chest pain after it has already begun.
The drug can also lower a person's risk of cardiovascular events related to high blood pressure, such as strokes and heart attacks.
Norvasc belongs to a class of drugs called calcium channel blockers, which block the flow of calcium into heart muscles and the muscles along the walls of blood vessels.
Because the contraction of these muscles depends on calcium, Norvasc relaxes and widens blood vessels, thereby improving blood flow.
Doctors also sometimes prescribe Norvasc "off-label" for the treatment of cluster headaches, migraines, Raynaud's syndrome (a blood vessel disorder), and congestive heart failure.
Manufactured by Pfizer, Norvasc was first approved by the Food and Drug Administration (FDA) in 1987.
In the early 1990s, researchers conducted the so-called PRAISE study, which was backed by Pfizer, to determine if Norvasc could help reduce the risk of death in people with severe heart failure.
Though the study found little overall benefits to severe heart failure patients, it suggested that Norvasc might prolong the life of a subgroup of people with heart failure from non-ischemic cardiomyopathy (cardiac muscle damage not associated with low blood supply to the coronary arteries).
To investigate this possibility, Pfizer-sponsored the PRAISE-2 study, which found no benefit to the subgroup in the PRAISE-1 trial and was presented at a conference in 2000.
However, results of the study weren't published in an academic journal until 2013, leading some experts to question whether Pfizer intentionally delayed publication to prevent the data and findings from being publicly available.
People with a known sensitivity to amlodipine should not take Norvasc.
Though Norvasc is used to treat angina, worsening chest pain and heart attacks can develop after starting or increasing your dose of the drug — this is especially true for people with severe obstructive coronary artery disease.
Norvasc can also cause symptomatic hypotension (low blood pressure), particularly in people with a heart valve problem called aortic stenosis.
Before starting Norvasc, let your doctor know if you ever had heart disease or liver problems, as you may require a different course of Norvasc treatment.
Pregnancy and Norvasc
Norvasc poses a possible hazard to unborn infants.
Animal studies have shown that Norvasc increases the risk of death of fetuses in utero, decreases litter size, and prolongs both pregnancy and labor duration, but there have been no adequate and well-controlled studies in pregnant women.
The drug should therefore only be used during pregnancy if the benefits to the mother outweigh the risks to the unborn child.
Women who are breastfeeding should not use Norvasc because it's unknown if the drug is excreted in breast milk.
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Norvasc Side Effects
Common Side Effects of Norvasc
The most common side effect of Norvasc is edema, or swelling of the hands, feet, ankles, or lower legs. You are more likely to experience edema with higher doses of Norvasc. Other common side effects of Norvascinclude:
Severe Side Effects of Norvasc
Taking Norvasc can result in several serious side effects. Seek medical help immediately if you experience:
- More frequent or severe chest pain
- Palpitations (rapid, strong, or irregular heartbeats)
Rare Side Effects of Norvasc
In clinical trials, Norvasc has been associated with numerous rare side effects, which affect less than one percent of people. These include, but are not limited to:
Contact your doctor if you experience any severe side effects.
When taking Norvasc, you should not take more than 20 milligram (mg) of the cholesterol-lowering medication simvastatin (Zocor, Vytorin).
Other drugs that may interact with Norvasc include:
Though Norvasc isn't known to interact with many drugs, make sure to tell your doctor about any medications (prescription, non-prescription, and over-the-counter), illegal and recreational drugs, herbal remedies, and supplements you are taking.
Norvasc and Grapefruit
There is little evidence that grapefruit and grapefruit juice will interact with Norvasc. However, to be safe, consider avoiding all grapefruit products if you're also taking Norvasc.
Norvasc comes in three tablet sizes, which should be taken once a day, with or without food: 2.5 mg, 5 mg, and 10 mg.
Adults typically start out with a 5 mg dose, with a maximum dose of 10 mg. Adults who are small, fragile, elderly, or have liver problems may be started on a 2.5 mg dose.
Children ages 6 to 17 may be given doses of 2.5 to 5 mg — a daily dose of over 5 mg has not been studied in children. The effect of Norvasc on children under 6 years old is unknown.
Norvasc overdose can result in rapid heartbeat and severe hypotension, possibly resulting in dizziness and fainting.
If you believe you or someone else has overdosed, call your local poison control center, or go to the nearest hospital emergency room immediately.
If someone taking Norvasc has collapsed or is not breathing, call 911.
Missed Dose of Norvasc
Take your dose of Norvasc at the same time every day.
If you miss a dose of Norvasc, take it as soon as you remember.
If has been more than 12 hours since your missed dose, wait and take your next dose at your normal time.
Q: I am on Norvasc (amlodipine). Can this medication make you gain weight?
A: Weight gain is a rare side effect of Norvasc (amlopodine) occurring in less than 1 percent of people taking the drug. Because weight gain with Norvasc happens so infrequently, it is difficult to know whether the weight gain is caused by Norvasc or another factor. If you see a rapid increase in weight gain or fluid retention then contact you health care provider and let him know what you are noticing. A low-salt and low-fat diet may help with the weight gain. You may also find helpful information at: //www.everydayhealth.com/drugs/norvasc.
Q: My doctor increased Norvasc from 5 mg to 10 mg, once daily. Now my ankles and feet are swollen to the extent my shoes are tight. Is this due to the 10 mg Norvasc?
Q: Are there any reports of Norvasc causing swelling or pain in the legs or ankles?
Q: What pain killers, if any, can be taken if you are using Norvasc?
Q: I take Norvasc. Is it safe to eat grapefruit with that medication?
A: There is nothing in the literature that reveals any significant interactions between the calcium channel blocker Norvasc (amlodipine) and grapefruit.
Q: Is it okay to take more than one Norvasc per day?
A: Norvasc (amlodipine) is a calcium-channel blocker which is used to treat high blood pressure and other heart conditions. Norvasc comes in three different strength tablets; 2.5 mg, 5 mg, and 10 mg. The maximum dose of Norvasc is 10 mg daily. Patients who are elderly, have liver impairment or kidney impairment may need lower doses. Talk to your health care provider about what dose of Norvasc is right for you. You may also find helpful information on Norvasc at //www.everydayhealth.com/drugs/norvasc. Laura Cable, PharmD
Q: Does Lipitor cause leg numbness? Does Norvasc induce a dry cough with a thick mucus?
A: Lipitor may cause something called, "peripheral neuropathy." Leg numbness is a symptom of this. If you feel that the Lipitor is causing this, please contact your physician as soon as possible. This obviously could be a sign of something much more serious. Norvasc is a calcium channel blocker and is sometimes prescribed for asthmatics and people with severe bronchitis to help keep their bronchiole tubes open as well as cough out the sputum. However, most of the time it is prescribed for blood pressure and angina. In general, it is important to drink a lot of water with this medication, however if you feel that you are coughing too often and the mucus is discolored, contact your physician as this may be a sign of a much more serious problem. Feel free to visit our site for more information about these two medications: //www.everydayhealth.com/drugs/lipitor & //www.everydayhealth.com/drugs/norvasc
Q: What is Norvasc? Are there side effects to taking it?
A: Norvasc (amlodipine) is classified as a dihydropyridine calcium channel blocker. Norvasc is approved for the treatment of high blood pressure and angina. According to medical references, the most common side effect (reported in greater than 10 percent of studied patients) is peripheral edema. Peripheral edema involves swelling of tissues and usually involves the lower limbs. Other side effects reported of patients on Norvasc include the following: flushing, palpitation, dizziness, fatigue, tiredness, rash, itching, male sexual dysfunction, nausea, abdominal pain, upset stomach, muscle cramps, weakness, shortness of breath and pulmonary edema. This is not a complete listing of all possible side effects of Norvasc. Also, keep in mind that there is no guarantee that you will experience these side effects, they are just possibilities. If you think that you are experiencing a side effect from your medication, tell your physician. Do not stop taking any medication or change the dose without first talking to your physician. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jen Marsico, RPh
Q: I just started Norvasc and have hypothyroidism. Could this medicine affect my thyroid?
A: Norvasc (amlodipine) is a calcium channel blocker used to treat high blood pressure and other heart conditions. Generally speaking, drug interactions fall into three main categories: Drug-drug (i.e., prescription, over-the-counter, herbals, dietary supplements) interactions occur when two or more drugs react with each other. Drug-diet (food/drink) interactions result from drugs reacting with foods or drinks. Drug-disease interactions may occur when an existing medical condition makes certain drugs potentially harmful. Potential drug interactions 1) Norvasc has an interaction with grapefruit juice. It is best to avoid grapefruit and grapefruit juice while taking Norvasc. Taking them together may lead to increased side effects from Norvasc. According to prescribing information, Norvasc is not expected to affect the thyroid. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your healthcare providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Laura Cable, PharmD., BCPS
Q: I have hypertension and take Norvasc 5 mg (amlodipine). What other alternative can I take?
A: Hypertension or high blood pressure is a condition where the pressure inside the blood vessels is elevated. Hypertension that is left untreated can cause damage to the heart and other organs and could lead to heart failure or heart attack. A goal blood pressure for those with hypertension is less than 140/90, those with certain diseases such as diabetes or kidney disease may have a goal blood pressure of less than 130/80. There are many medication classes available for the treatment of hypertension. According to hypertension guidelines, most patients should be started on a diuretic medication such as hydrochlorothiazide. Many patients will need to be on two or more medications, so in addition to a diuretic a patient may be started on an ACE inhibitor such as lisinopril, an ARB such as losartan, a beta blocker such as metoprolol, or calcium channel blocker such as amlodipine (Norvasc). Patients with other conditions such as diabetes, kidney disease or a past heart attack should be started on certain medications before other ones are added. Those with thyroid disease can on any of the above classes of hypertension medications. Your doctor will help you decide which medication would be best for you. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Laura Cable, PharmD
Q: Is it okay to eat grapefruit or have grapefruit juice if you're taking Norvasc?
A: According to the package insert for Norvasc, there is no interaction with Norvasc and grapefruit juice. Norvasc can be taken with most drinks, including grapefruit juice. This information is solely educational. It's important to consult with your physician or health care provider about any specific questions regarding your medical conditions or medications; particularly before taking any action. Kristen Dore, PharmD
Q: What are the side effects of Norvasc?
A: Norvasc (amlodipine) is a medication used to treat high blood pressure. Studies show that some of the common side effects are dizziness, headache, and rarely fainting as a result of low blood pressure. Some studies suggest that taking at bedtime can alleviate fainting. Please report to a physician if any of the side effects are bothersome. Side effects vary from person to person and studies show that after prolonged medication use human body gets used to the medication and side effects subside. It is important to take the medication as prescribed for proper blood pressure control. For more information, please see //www.everydayhealth.com/drugs/norvasc.
Q: I take Norvasc just before going to bed. Can I safely have a glass of wine in the evening as well?
A: The interaction between alcohol and Norvasc (amlodipine) is moderate and not serious. However, patients are advised to avoid drinking alcohol while taking amlodipine. Alcohol can further lower your blood pressure and may increase some of the side effects of amlodipine, such as dizziness, fainting, and feeling light-headed, especially among the elderly. Long-term use of alcohol can also actually worsen hypertension and increase a patient's risk of other cardiac problems. While there is some research that shows that light alcohol consumption (especially of red wine) can protect the heart, that research is not widely accepted in the medical community. Therefore, patients with hypertension or heart problems should discuss alcohol intake with their doctor or cardiologist. For more information on Norvasc, go to //www.everydayhealth.com/drugs/norvasc. Leslie Ako-Mbo, PharmD
Q: Can Norvasc prevent weight loss?
A: Norvasc (amlodipine) belongs to a class of drugs called calcium channel blockers (CCBs) that relaxes (widens) blood vessels and improves blood flow. Norvasc is used to treat hypertension (high blood pressure), angina (chest pain), and other conditions caused by coronary artery disease. Common side effects of Norvasc include headache, dizziness, drowsiness, tiredness, stomach pain, and flushing. According to the prescribing information for Norvasc, weight gain has been reported in patients using the medication. However, it is reported as either occurring uncommonly or it is unclear if Norvasc is the cause of weight gain or not. Consult your doctor about your weight gain. This is not a complete list of the side effects associated with Norvasc. Sarah Lewis, PharmD
Q: I have taken Norvasc for more than 10 years. I started taking the generic form with a new pharmacy and have developed a dry persistent cough. Is it possible fillers in the generic form are causing this?
A: Norvasc (amlodipine) belongs to a class of drugs called the calcium channel blockers (CCBs). Calcium channel blockers work by dilating or widening blood vessels to improve blood flow or circulation. Norvasc is used to treat hypertension (high blood pressure) and angina (chest pain), either alone or in combination with other medications. Common side effects of Norvasc include dizziness, drowsiness, tiredness, headache, muscle cramps, weakness, nausea, and stomach pain. According to the prescribing information for Norvasc, coughing is a side effect that is reported rarely (less than one percent of patients) in patients taking this medication. If you were not experiencing cough while taking the brand-name product, it could be something in the generic formulation, or it could be totally unrelated. Consult with your doctor about your cough to make sure it is not a symptom of an underlying medical condition. Your doctor is best able to properly evaluate you and determine whether or not your cough is related to the medication. It may be that you need to try the brand name again to see if the cough goes away. Your doctor can specify the need for the brand name product to your pharmacist. Your pharmacist can advise you on your insurance requirements if the brand name product is necessary for you. Do not stop your current medication without talking to your doctor first. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action.
Video: Amlodipine (Norvasc): Drug to Treat High Blood Pressure
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