Common use: Norvasc for hypertension and angina
Norvasc (amlodipine) is a dihydropyridine calcium channel blocker primarily prescribed to treat high blood pressure (hypertension) and to prevent chest pain from chronic stable angina or vasospastic (Prinzmetal) angina. By lowering blood pressure, Norvasc helps reduce the risk of heart attack, stroke, and kidney problems associated with long-term hypertension. In angina, it reduces the heart’s oxygen demand and helps prevent coronary artery spasms, decreasing the frequency of chest pain episodes and improving exercise tolerance. Clinicians may also use amlodipine to help manage coronary artery disease with documented ischemia, and in select cases off-label for conditions such as Raynaud phenomenon, when appropriate.
How Norvasc works: A calcium channel blocker
Amlodipine blocks L-type calcium channels in vascular smooth muscle, leading to vasodilation—especially in the arterial system. This reduces systemic vascular resistance and lowers blood pressure. In the coronary circulation, vasodilation improves oxygen delivery and reduces coronary vasospasm, which helps prevent angina attacks. Because amlodipine has a long half-life, it provides smooth, 24-hour control with once-daily dosing and a lower likelihood of abrupt blood pressure swings. Unlike beta-blockers, Norvasc does not slow the heart rate significantly and generally preserves cardiac contractility, making it a useful option for many patients, including those with coexisting conditions where heart rate reduction is not desired.
Dosage and direction
Adults with hypertension or angina typically start at 5 mg once daily. Depending on blood pressure response and tolerability, the dose may be titrated between 2.5 mg and 10 mg once daily. For older adults, frail patients, or those with significant hepatic impairment, an initial dose of 2.5 mg once daily is often preferred. Dose adjustments usually occur every 7 to 14 days, allowing time to assess the full effect. Amlodipine can be taken with or without food, ideally at the same time each day. Swallow tablets whole with water, and do not crush unless your clinician or pharmacist confirms your specific tablet can be safely split or crushed.
Pediatric dosing for hypertension (ages 6 to 17 years) is typically 2.5 mg to 5 mg once daily, guided by blood pressure goals and tolerability. In angina, titration should be cautious in patients with severe coronary artery disease, as rare worsening of angina or myocardial infarction has been reported at therapy initiation or dose increases. Do not self-adjust your dose. If you experience excessive dizziness, lightheadedness, ankle swelling, or chest discomfort after a dose change, contact your clinician promptly. Continue lifestyle measures—such as reduced sodium intake, regular physical activity as advised, healthy weight management, and limited alcohol—to enhance blood pressure control alongside medication.
Precautions
Use amlodipine cautiously if you have low baseline blood pressure, advanced liver disease, severe aortic stenosis, or heart failure. Although Norvasc is generally safe in heart failure with reduced ejection fraction, it can cause fluid retention (peripheral edema), so clinicians monitor for swelling and adjust therapy if needed. Dizziness, flushing, or fatigue may occur during initiation or dose changes; rise slowly from sitting or lying positions and avoid driving until you know how you respond. Amlodipine does not treat acute chest pain—keep fast-acting nitroglycerin available if prescribed and seek emergency care for new, severe, or worsening chest pain or shortness of breath.
Pregnancy and lactation considerations require individualized risk–benefit assessment. Limited human data suggest amlodipine may be compatible with breastfeeding at usual doses, but you should discuss this with your clinician. Alcohol can intensify blood pressure lowering and dizziness. While grapefruit and grapefruit juice have a modest effect on amlodipine metabolism compared to some other calcium channel blockers, it is still prudent to use them sparingly or consistently so your clinician can interpret your response. Do not abruptly discontinue antihypertensive therapy without guidance; sustained blood pressure control is key to reducing long-term cardiovascular risk.
Contraindications
Do not use Norvasc if you have a known hypersensitivity to amlodipine or other dihydropyridine calcium channel blockers. It is generally contraindicated in patients with severe hypotension (for example, systolic blood pressure below 90 mmHg), shock (including cardiogenic shock), or acute hemodynamic instability. Severe aortic stenosis is a condition where vasodilators require great caution because sudden afterload reduction may compromise coronary perfusion; specialized evaluation is advised. If you have persistent chest pain that is unstable or rapidly worsening, emergency evaluation is essential before initiating or adjusting vasodilatory therapy.
Possible side effects
Common side effects include ankle or foot swelling (peripheral edema), flushing, headache, dizziness, fatigue, and palpitations. These are often dose related and may improve as your body adapts or with dose adjustments. Gastrointestinal effects such as nausea or abdominal discomfort can occur but are usually mild. Some patients notice mild sleep disturbances or muscle cramps. Gum overgrowth (gingival hyperplasia) can occur with calcium channel blockers; excellent dental hygiene and routine dental care help reduce risk. If you experience bothersome swelling, discuss strategies such as dose titration, compression socks, or medication adjustments with your clinician.
Less common but important effects include significant hypotension, fainting, worsening angina during dose changes, and rare hypersensitivity reactions such as rash or angioedema (swelling of the face, lips, tongue, or throat). Very rare reports include elevated liver enzymes or jaundice; seek evaluation for persistent fatigue, dark urine, or yellowing of the skin/eyes. Seek emergency care for severe dizziness, fainting, chest pain, shortness of breath, rapid or irregular heartbeat, or swelling of the tongue/throat. To help your healthcare team monitor safety, report new symptoms, other medicines you take, and any herbal or over-the-counter products you add to your regimen.
Drug interactions
Amlodipine is metabolized by CYP3A4. Strong or moderate CYP3A4 inhibitors—such as clarithromycin, erythromycin, ketoconazole, itraconazole, ritonavir, and some grapefruit products—can increase amlodipine levels, raising the risk of hypotension and edema. CYP3A4 inducers—such as rifampin, carbamazepine, phenytoin, phenobarbital, and St. John’s wort—may reduce amlodipine effectiveness; blood pressure should be monitored, and dose adjustments considered. Combining Norvasc with other blood pressure–lowering agents (ACE inhibitors, ARBs, thiazides, beta-blockers, alpha-blockers) can be beneficial but increases the chance of dizziness or low blood pressure, especially when starting or escalating doses.
Important specific interactions include simvastatin: when used together, the maximum recommended simvastatin dose is 20 mg daily due to increased simvastatin exposure and myopathy risk. Amlodipine may increase levels of tacrolimus and, less consistently, cyclosporine; monitor drug levels and renal function when combined. Phosphodiesterase-5 inhibitors (sildenafil, tadalafil) can add to blood pressure lowering—use cautiously. NSAIDs can blunt antihypertensive effects in some patients, particularly with chronic use. Alcohol can enhance dizziness and hypotension. Always provide a complete medication list to your clinician and pharmacist so they can screen for interactions and guide safe co-therapy.
Missed dose
If you miss a dose of Norvasc, take it as soon as you remember on the same day. If it is close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not double up to make up for a missed dose, as this increases the risk of side effects like dizziness or hypotension. Setting reminders, using a pill organizer, or aligning your dose with a daily routine (such as brushing teeth) can improve adherence. If you miss doses frequently, speak with your clinician about strategies to simplify your regimen.
Overdose
Amlodipine overdose can cause profound peripheral vasodilation, severe hypotension, reflex tachycardia, dizziness, and in extreme cases shock or metabolic disturbances. If an overdose is suspected, call emergency services or Poison Control (in the U.S., 1-800-222-1222) immediately. Management is supportive: position the patient supine with legs elevated, administer intravenous fluids, consider vasopressors if needed, and treat symptoms under medical supervision. Activated charcoal may be considered if the ingestion is recent and there are no contraindications. Intravenous calcium may help counteract calcium channel blockade in severe cases. Never share medications, and keep all medicines out of reach of children and pets.
Storage
Store Norvasc tablets at room temperature, ideally 20°C to 25°C (68°F to 77°F), in a dry place away from direct light and humidity. Keep tablets in their original, tightly closed container and avoid storing in bathrooms where moisture is high. Do not use past the expiration date. Safely discard unused or expired medication through take-back programs when available, or follow local guidance for safe disposal. Always keep medications out of reach of children.
U.S. sale and prescription policy: safe access through HealthSouth Hospital of Altamonte Springs
In the United States, amlodipine (Norvasc) is a prescription-only medication. While some consumers search phrases like “buy Norvasc without prescription,” it is neither safe nor legal to obtain prescription medicines without a valid prescription from a licensed clinician. Doing so increases the risk of counterfeit or substandard products, harmful interactions, and lack of appropriate monitoring. The responsible pathway is evaluation by a qualified professional who can confirm the indication, select the right dose, review interactions, and provide ongoing follow-up to ensure that blood pressure and symptoms are well controlled.
HealthSouth Hospital of Altamonte Springs offers a compliant, structured solution for access: convenient telehealth evaluation by licensed clinicians (when available in your state), pharmacist counseling, transparent pricing, and fulfillment through licensed U.S. pharmacies. If appropriate, a legitimate prescription is issued after clinical assessment—no shortcuts, no unsafe “no-Rx” dispensing. This model protects your health and privacy while keeping you on the right side of U.S. law. If cost is a concern, ask about generics (amlodipine), discount programs, and 90-day supplies. For ongoing therapy, schedule refills in advance so you never run out of your blood pressure medication.
