Amlodipine

Amlodipine is a long-acting Dihydropyridine Calcium Channel Blocker (DHP CCB).

It primarily causes arterial vasodilation and reduces systemic vascular resistance.

Used in:

• Hypertension
• Stable Angina
• Vasospastic angina

→ Calcium Channel Blockers

Amlodipine blocks L-type calcium channels in vascular smooth muscle.

This results in:

• ↓ Intracellular calcium
• Arterial vasodilation
• ↓ Systemic Vascular Resistance (SVR)
• ↓ Afterload

Minimal direct effect on:

• SA node
• AV node
• Myocardial contractility

Primary action = vascular.

• ↓ Blood pressure
• ↓ Afterload
• Mild reflex sympathetic activation possible

Does NOT significantly:

• Slow heart rate
• Depress AV conduction

Onset:

• Gradual

Half-life:

• Long (~30–50 hours)

Dosing:

• Once daily

Provides smooth 24-hour blood pressure control.

Hypertension:

• First-line option
• Often combined with:
  • ACE Inhibitors
  • ARBs
  • Thiazide Diuretics

Stable Angina:

• Reduces afterload
• Improves myocardial oxygen balance

Vasospastic Angina:

• Coronary vasodilation

Common:

• Peripheral edema
• Headache
• Flushing
• Gingival hyperplasia

Mechanism of edema:

• Arteriolar dilation without equivalent venodilation
• Increased capillary hydrostatic pressure

Edema improves when combined with:

• ACE Inhibitors
• ARBs

Compared to:

• Verapamil
• Diltiazem

Amlodipine:

• Does NOT slow AV node
• Does NOT significantly reduce heart rate
• Safe in HFrEF (unlike non-DHP CCBs)

• DHP CCB
• Potent arterial vasodilator
• Once-daily dosing
• Causes peripheral edema
• Safe in HFrEF
• Excellent first-line antihypertensive

• Calcium Channel Blockers
• Dihydropyridines
• Hypertension
• Anti-Anginal Therapy
• ACE Inhibitors