Norvasc (amlodipine besylate) is a leading calcium channel blocker prescription medication designed for the management of hypertension and chronic stable angina. As a first-line antihypertensive agent, it works by relaxing blood vessels, allowing blood to flow more easily and reducing the heart’s workload. Its long half-life and consistent 24-hour efficacy make it a cornerstone in cardiovascular risk management protocols, offering reliable control with a favorable side effect profile. This medication is widely trusted by clinicians for its proven track record in improving patient outcomes.

Features

• Active ingredient: Amlodipine besylate
• Available in tablet strengths: 2.5 mg, 5 mg, and 10 mg
• Class: Dihydropyridine calcium channel blocker (CCB)
• Administration: Oral, once daily
• Onset of action: Gradual, within 6–12 hours
• Half-life: Approximately 30–50 hours
• Bioavailability: 64–90%
• Excretion: Primarily hepatic metabolism, renal elimination

Benefits

• Provides consistent 24-hour blood pressure control with a single daily dose
• Reduces cardiac workload and myocardial oxygen demand, beneficial in angina management
• Lower risk of reflex tachycardia compared to other vasodilators
• Demonstrated efficacy in diverse patient populations, including elderly and renally impaired individuals
• May be used as monotherapy or in combination with other antihypertensive agents
• Does not adversely affect lipid profiles or glucose metabolism

Common use

Norvasc is primarily indicated for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also approved for the management of chronic stable angina and vasospastic (Prinzmetal’s) angina. Clinicians may prescribe it off-label for certain cases of Raynaud’s phenomenon and as part of combination therapy in heart failure management when appropriate. The medication is suitable for long-term maintenance therapy in chronic cardiovascular conditions.

Dosage and direction

The recommended initial dose for hypertension or angina is 5 mg orally once daily. This may be increased to a maximum dose of 10 mg daily based on therapeutic response and tolerability. Small or fragile patients, patients with hepatic impairment, or those taking concomitant antihypertensive medications may be started on 2.5 mg daily. Dosage adjustments should occur at 7- to 14-day intervals. Administration may occur with or without food, though consistency in timing is recommended for optimal therapeutic steady-state concentrations.

Precautions

Patients should be monitored for peripheral edema, which is dose-dependent and more common at higher doses. Blood pressure should be regularly assessed during therapy initiation and titration. Use with caution in patients with severe aortic stenosis due to reduced afterload reduction benefits. Hepatic impairment may require dosage adjustment as amlodipine is extensively metabolized by the liver. Patients with heart failure should be monitored for worsening symptoms, though this is less common with dihydropyridine CCBs. Abrupt discontinuation is generally not associated with rebound hypertension.

Contraindications

Norvasc is contraindicated in patients with known hypersensitivity to amlodipine or any component of the formulation. It should not be used in patients with severe hypotension (systolic BP <90 mmHg). The medication is contraindicated in cardiogenic shock and should be used with extreme caution in patients with obstructive cardiomyopathy. Concomitant use with strong CYP3A4 inhibitors may require dosage adjustment or alternative therapy selection.

Possible side effects

Common side effects (≥1%) include peripheral edema (dose-dependent), headache, fatigue, nausea, abdominal pain, and palpitations. Less frequent adverse reactions (<1%) may include dizziness, flushing, somnolence, and gingival hyperplasia. Serious but rare side effects include hypotension, syncope, and worsening angina or myocardial infarction—particularly during initiation or dosage titration. Allergic reactions including rash, pruritus, and urticaria have been reported.

Drug interaction

Moderate interactions occur with strong CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) which may increase amlodipine concentrations. Concurrent use with other antihypertensive agents may potentiate blood pressure lowering effects. Simvastatin coadministration may increase simvastatin concentrations. Use with sildenafil or other phosphodiesterase-5 inhibitors may enhance hypotensive effects. Calcium supplements may reduce the effectiveness of calcium channel blockers. Monitoring is recommended when used with cyclosporine due to potential increased cyclosporine concentrations.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed administration. Consistent daily dosing is important for maintaining therapeutic blood levels given the medication’s long half-life.

Overdose

Overdose may manifest as pronounced peripheral vasodilation with marked hypotension and possibly reflex tachycardia. Bradycardia may occur in some cases. Management includes active cardiovascular support with elevation of extremities and judicious administration of fluids. Vasoconstrictors such as norepinephrine or phenylephrine may be considered with close hemodynamic monitoring. As amlodipine is highly protein-bound, dialysis is not likely to be beneficial. Gastric lavage may be considered if presentation is early after ingestion.

Storage

Store at controlled room temperature (20–25°C or 68–77°F) with excursions permitted between 15–30°C (59–86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not transfer tablets to other containers as this may affect stability.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Norvasc is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to therapy may vary, and patients should follow their prescribing physician’s instructions regarding dosage, administration, and monitoring. Never adjust dosage or discontinue medication without consulting your healthcare provider.

Reviews

Clinical trials and post-marketing surveillance demonstrate Norvasc’s efficacy in blood pressure control with once-daily dosing convenience. Physicians report reliable antihypertensive effects with generally good tolerability, though peripheral edema remains a consideration at higher doses. Patients often appreciate the minimal dosing frequency and stable therapeutic effect. The medication maintains a favorable position in treatment guidelines due to its proven efficacy across diverse populations and well-characterized safety profile spanning decades of clinical use.