Amlodipine is a medication used to treat hypertension (high blood pressure) and angina (heart-related chest pain).
A calcium channel blocker, amlodipine relaxes blood vessels and decreases blood pressure, making it easier for your heart to pump blood throughout the body.
Sold as a generic drug or under brand names Katerzia and Norvasc, amlodipine often causes edema, the abnormal swelling of tissues due to fluid accumulation in tissues.
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This article explains why amlodipine causes swelling and what can be done to relieve this common but frustrating side effect.
How Amlodipine Works
Amlodipine is a calcium channel blocker for treating high blood pressure and angina. It works by affecting the movement of calcium into the cells of the heart and blood vessels.
As a treatment for hypertension, amlodipine works to lower blood pressure by relaxing blood vessels so the heart does not have to pump as hard.
As a treatment for angina, amlodipine increases blood supply to the heart. This does not stop chest pain once it starts, but when taken regularly, amlodipine prevents chest pain from starting.
Dosage
Amlodipine is available as a tablet and formulated in doses of 2.5, 5, and 10 milligrams (mg).
The standard recommended dose is 5 mg once daily, increasing to a maximum dose of 10 mg once daily if needed.
People who are smaller, elderly, or have liver problems should be started at a dose of 2.5 mg and increased gradually to obtain the desired response.
Swelling as a Side Effect of Amlodipine
Edema, or the abnormal swelling of tissues caused by the accumulation of fluids, is a common side effect of calcium channel blockers, especially amlodipine.
Types of Swelling
Amlodipine-associated swelling can affect the hands, feet, ankles, or lower legs.
Pedal edema (swelling in the lower legs and feet) is the most common type of swelling from amlodipine. One study found that 15.6% of amlodipine users experience pedal edema.
Causes of Swelling
Edema commonly occurs with amlodipine and other calcium channel blockers because the drugs trigger the dilation of blood vessels. The dilation, in turn, lowers the blood pressure and improves blood flow throughout the body.
However, the improved blood flow can increase the pressure within smaller blood vessels called capillaries. This can cause fluids to seep through the walls of the vessels into surrounding tissues.
The risk of edema is largely dose-dependent, meaning that higher doses of amlodipine correspond to a greater likeliness (or the worsening) of symptoms. For example, rates of edema at a dose of 2.5 mg were 1.8%. That jumped to 10.8% at 10 mg doses.
Edema from amlodipine is also two to three times more common in females than males.
In addition, the likelihood of edema increases the longer you take amlodipine. In one study, people who took amlodipine for five years or more were 20 times more likely to experience swelling as a side effect.
Other Reasons for Swelling
Foot and ankle swelling can also be a sign of:
- Congestive heart failure (HF)
- Chronic kidney disease
- Liver disease
- Thyroid disorders
- Venous insufficiency
- Venous thrombosis
If you have unexplained edema, see your healthcare provider.
Other Side Effects of Amlodipine
In addition to swelling, other side effects of amlodipine include:
- Dizziness or lightheadedness
- Drowsiness
- Excessive tiredness
- Flushing
- Headache
- Nausea
- Stomach pain
- Upset stomach
Amlodipine can also have more serious side effects. If you experience any of the following, contact your healthcare provider:
- Fainting
- More frequent or more severe chest pain
- Rapid, pounding, or irregular heartbeat
Overdose Warning
It is possible to overdose on amlodipine and other calcium channel blockers. Never take more than the recommended dose. Signs of overdose include:
- Constipation
- Confusion
- Drowsiness
- Slowed heartbeat
- Slurred speech
- Shortness of breath
- Weakness
- Nausea
- Increased blood sugar
If an overdose is suspected, call the Poison Control Hotline at 1-800-222-1222, available 24 hours sevens days a week. Do not induce vomiting unless a trained poison control professional tells you to do so.
How to Ease Swelling
Edema from amlodipine can often be managed with at-home strategies. Your healthcare provider may recommend taking your medication at night instead of in the morning if swelling is a problem.
Other ways to ease foot and ankle swelling include:
- Avoid prolonged standing or sitting.
- Elevate your feet above your heart.
- Get up and walk around to keep fluid circulating.
- Make sure you drink enough water—dehydration can prompt the body to retain excess fluid.
- Massage your feet and legs to promote circulation.
- Soak your feet, ankles, and calves in Epsom salts to draw out fluid.
- Wear compression socks to prevent fluid from collecting in your feet and ankles.
Hypertension (High Blood Pressure) Treatment
When to Call Your Healthcare Provider
If you experience edema while taking amlodipine, tell your healthcare provider. Do not stop treatment without discussing it first.
Edema in the feet, lower legs, and hands is also a symptom of heart failure and pulmonary hypertension. If you experience edema while taking amlodipine, tell your healthcare provider. You may need additional tests to rule out these conditions.
To manage edema, your healthcare provider may lower the dose, change your medication, or add another medication.
Diuretics (water pills) are often prescribed alongside amlodipine. However, diuretics are not always effective for relieving edema as a side effect of amlodipine.
An ACE-inhibitor or angiotensin II receptor blocker may be added to your medications. If you're already taking these medications, you may be given a higher dose.
Your healthcare provider may also prescribe a different calcium channel blocker, such as diltiazem, lacidipine, lercanidipine, or verapamil, or switch you to another class of drugs.
Summary
Amlodipine is a type of drug called a calcium channel blocker used to treat high blood pressure and angina. One of the more common side effects of amlodipine is edema, or the abnormal swelling of tissue due to the build-up of fluid. Although the ankles and feet are most commonly affected, the hands and lower legs may also experience swelling.
Calcium channel blockers like amlodipine help lower blood pressure by dilating blood vessels. The increased blood flow, in turn, intensifies the pressure within smaller blood vessels, causing fluids to leak through the walls of the vessels into surrounding tissues.
If edema occurs while taking amlodipine, call your healthcare provider. You may be switched to another calcium channel blocker or a different class of blood pressure medication. Or, the amlodipine dose may simply be reduced to see if that helps. Never stop or alter treatment without first speaking to your healthcare provider.
Living With Hypertension
