Home Drug Guide Amlodipine Maleate

Drug Guide

Generic Name

Amlodipine Maleate

Brand Names Amvaz

Classification

Therapeutic: Antihypertensive, Antianginal

Pharmacological: Calcium channel blocker, dihydropyridine

FDA Approved Indications

  • Chronic stable angina
  • Varying forms of hypertension

Mechanism of Action

Amlodipine inhibits calcium ion influx across cell membranes in vascular smooth muscle and cardiac muscle, resulting in vasodilation and reduced peripheral resistance, which decreases blood pressure and myocardial oxygen demand.

Dosage and Administration

Adult: Initial dose typically 5 mg once daily; may be titrated up to 10 mg once daily based on response.

Pediatric: Not approved for pediatric hypertension or angina.

Geriatric: Start at lower dose (e.g., 2.5 mg) and titrate cautiously.

Renal Impairment: Use with caution; no specific adjustment needed but monitor closely.

Hepatic Impairment: Initial dose of 2.5 mg is recommended; titrate cautiously.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Widely distributed; protein binding approximately 97%.

Metabolism: Extensively metabolized in the liver via CYP3A4.

Excretion: Primarily eliminated via urine and feces; metabolites predominantly excreted in urine.

Half Life: 30 to 50 hours, allowing once-daily dosing.

Contraindications

  • Hypersensitivity to amlodipine or other dihydropyridines.
  • Severe aortic stenosis.

Precautions

  • Use cautiously in cases of severe hepatic impairment.
  • Monitor for hypotension, especially in volume-depleted patients.

Adverse Reactions - Common

  • Edema (pedal) (Common)
  • Headache (Common)
  • Dizziness (Common)
  • Flushing (Common)

Adverse Reactions - Serious

  • Hypotension (Uncommon)
  • Palpitations or tachycardia (Uncommon)
  • Myocardial ischemia (in cases of excessive vasodilation) (Rare)

Drug-Drug Interactions

  • Simvastatin (increased risk of myopathy)
  • Beta-blockers (combine cautiously due to potential for excessive hypotension)
  • Grapefruit juice (may increase plasma levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure and heart rate before and after administration.

Diagnoses:

  • Risk for hypotension
  • Ineffective tissue perfusion related to vasodilation.

Implementation: Administer consistently at the same time daily. Monitor for adverse reactions and efficacy.

Evaluation: Assess blood pressure regularly; evaluate for signs of adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Do not discontinue abruptly, especially if on antihypertensive therapy.
  • Notify healthcare provider of swelling, chest pain, or adverse reactions.
  • Limit alcohol intake and avoid grapefruit juice.
  • Rise slowly from sitting or lying position to minimize dizziness.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: Genetic polymorphisms in CYP3A4 can affect metabolism.

Lab Test Interference: Rare; monitor liver function in long-term use.

Overdose Management

Signs/Symptoms: Severe hypotension, tachycardia, arrhythmias, or dizziness.

Treatment: Supportive care including IV fluids or vasopressors; calcium gluconate may be used as an antidote in severe cases.

Storage and Handling

Storage: Store at room temperature (20-25°C).

Stability: Stable until the expiration date on the package.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.