Amlodipine is a calcium channel blocker taken once daily, usually as 5 mg or 10 mg tablets. It lowers high blood pressure and prevents angina. It is one of the most prescribed medicines in South Africa, and ankle swelling is its commonest side effect.

What is Amlodipine?

Amlodipine is a calcium channel blocker of the dihydropyridine group, a Schedule 3 medicine. It is dispensed under its own name and as Ciplavasc, Norvasc, Amloc and Austell Amlodipine.

Muscle in the walls of arteries needs calcium to contract. Amlodipine blocks the channels that let calcium into those cells, so the muscle relaxes. Arteries widen, resistance to blood flow falls, and blood pressure comes down. Because the heart pumps against less resistance and the coronary arteries are wider, it also reduces angina.

Two features explain why it is prescribed so heavily.

It is long-acting. One tablet gives cover across a full 24 hours, and because it leaves the body slowly, a single missed dose is less abrupt in effect than with a shorter-acting medicine.

It is metabolically neutral. Unlike some alternatives, amlodipine does not affect potassium, blood sugar or lung function. That makes it usable across a very wide range of people — including many with diabetes, asthma, gout or kidney impairment, where other blood pressure medicines are more constrained.

What is Amlodipine commonly used for?

High blood pressure is the dominant use, and it is worth being direct about what treatment is for.

Hypertension usually causes no symptoms at all. People feel exactly the same treated as untreated, which is why blood pressure tablets are among the most commonly abandoned medicines. The purpose is not how you feel today: sustained high blood pressure damages arteries, the heart, the kidneys, the eyes and the brain over years, and treating it substantially reduces the risk of stroke, heart attack and kidney failure.

Feeling fine is not evidence the medicine is unnecessary — it is what treated hypertension feels like.

Blood pressure medicines are also frequently combined, because two at moderate amounts usually control pressure better, and with fewer side effects, than one pushed to maximum. Amlodipine is commonly paired with an ACE inhibitor such as enalapril or a diuretic such as Ridaq — and that particular pairing has a practical bonus, covered below.

How Amlodipine fits into this medicine category

GroupExamplesHow it works
Calcium channel blockersAmlodipine (Ciplavasc, Amloc)Relaxes artery walls
ACE inhibitorsEnalapril, perindoprilBlocks a vessel-narrowing hormone
ARBsLosartan, valsartanSimilar target, without the cough
Thiazide diureticsHydrochlorothiazide (Ridaq)Removes excess fluid and salt
Beta blockersAtenolol, carvedilolSlows the heart, reduces its workload

Which is chosen depends on age, ethnicity, other conditions and response — South African guidelines often favour a calcium channel blocker or diuretic as a first choice in Black patients, in whom ACE inhibitors are somewhat less effective as single agents. See the heart, blood pressure and circulation medicines hub.

What to check before using Amlodipine

Take it at the same time each day, with or without food, and keep taking it even when you feel perfectly well.

Avoid grapefruit juice, which can raise amlodipine levels.

Tell your prescriber or pharmacist if:

Have your blood pressure checked regularly. Treatment is adjusted to your readings, and a home monitor is genuinely useful if you can get one.

Follow the dispensing label. This page does not set doses.

Possible cautions and when to ask a pharmacist or doctor

Ankle and leg swelling is the commonest effect, affecting a meaningful proportion of people. It happens because amlodipine widens small arteries more than veins, so fluid collects in the tissues. It is not usually a sign of heart or kidney trouble.

Three things are worth knowing about it. It is dose-related, so it often improves at a lower amount. It frequently improves when combined with an ACE inhibitor or ARB, which balances the pressure across the capillary. And it does not respond to diuretics, so adding a water tablet for it is not the answer.

Raise it with your prescriber rather than stopping the tablet — there are good options.

Flushing, headache and dizziness are common in the first weeks and usually settle.

Do not stop suddenly because you feel well or because of a side effect. Untreated hypertension resumes its damage silently, and there are many alternatives — switching is straightforward.

Get up slowly from sitting or lying if you feel light-headed.

Seek medical attention for chest pain that is new, worse or more frequent; breathlessness; fainting; a very fast or irregular heartbeat; marked swelling of the face or lips; swelling that worsens quickly or affects one leg only, which may indicate a clot; or yellowing of the skin or eyes.

Related medicine guides

Frequently asked questions

What is amlodipine 5 mg used for? High blood pressure and the prevention of angina. It is a calcium channel blocker taken once daily.

Is it the same as Ciplavasc or Norvasc? Yes. Different brand names for the same active ingredient.

Why are my ankles swelling? This is amlodipine’s commonest effect, caused by how it widens small arteries. It is dose-related and often improves when combined with an ACE inhibitor. Tell your prescriber rather than stopping.

Can I stop once my blood pressure is normal? No. The reading is normal because of the medicine. Stopping usually returns it to where it was.

When should I take it? Once daily at a consistent time, with or without food. Pick a time you will remember.

Can I take simvastatin with it? Yes, but the simvastatin amount is usually limited to 20 mg because amlodipine raises its levels. Check with your prescriber.