Amlodipine Nursing Implications |Patient Teachings |Interventions

Last updated on December 28th, 2023


In this article, you’ll learn about amlodipine nursing implications and patient teachings. Also, its dosage, mechanism of action, indication, side effects.

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Generic Name: Amlodipine

Brand Name(s): Norvasc, Katerzia

Amlodipine Class and Category

Pharmacologic class: Calcium channel blocker (Dihydropyridine calcium antagonist).

Therapeutic class: Antihypertensive, antianginal

Pregnancy category: C

Amlodipine Dosage

Adults: PO: initially: 5 mg, OD; maintenance dose: 5 – 10 mg, OD; maximum dose:10 mg, OD.

Small, fragile, elderly, or hepatic insufficiency: PO: initially: 2.5 mg, OD; maintenance dose: 2.5 – 10 mg, OD.

Pediatric dose (6 years and above): PO:2.5 – 5 mg, OD.

Amlodipine Pharmacokinetics and Pharmacodynamics

PO0.5 – 1 hour6 – 12 hours24 hours
Amlodipine pharmacokinetics & pharmacodynamics

Absorption: Slow absorption from the GI tract.

Distribution: Protein binding is more than 93%.

Metabolism: Hepatic.

Half-life: 30 – 50 hours (increased in elderly and patients with hepatic insufficiency).

Excretion: Mainly excreted via urine.

Amlodipine Mechanism of Action

Amlodipine inhibits the influx of extracellular calcium ions across slow calcium channels by binding to dihydropyridine and non-dihydropyridine cell membrane receptor sites on cardiac and vascular smooth muscle cells.

This lowers intracellular calcium levels, preventing smooth-muscle cell contractions and relaxing coronary and vascular smooth muscles.

As a result, the therapeutic effects are as follows.

  • Decreases both systolic and diastolic blood pressure.
  • Decreases peripheral vascular resistance by dilating coronary arteries and restoring blood flow. This lowers myocardial workload, oxygen demand, and vasospastic angina.

What are the indications of Amlodipine?

Amlodipine indications include:

  • To treat hypertension in adults and children above 6 years.
  • To treat coronary artery diseases (CAD), such as;
    • Chronic stable angina
    • Vasospastic angina (Prinzmetal’s or variant angina)
    • Angiographically documented coronary artery disease (CAD) without heart failure or an ejection fraction more than 40%.

What are the contraindications of Amlodipine?

The contraindications of amlodipine are:

  • Hypersensitivity to amlodipine and its components.

Caution: Hepatic impairment; severe aortic stenosis; severe obstructive coronary artery disease.

Amlodipine Interactions

  • Amlodipine effect is increased when take with moderate and strong CYP3A4 (such as ketoconazole, itraconazole, ritonavir).
  • Amlodipine may increase plasma levels of cyclosporine, simvastatin, and tacrolimus.
  • Concomitant use of ACE inhibitors may increase risk of hyperkalemia, hypotension, and renal dysfunction in patients with renal disease and diabetes.
  • Concomitant use of Sildenafil may result in severe hypotension.

Lab interactions

  • Amlodipine may increase LFTs.

Herbal/food interactions

  • Not known.

What are amlodipine side effects?

Amlodipine side effects / adverse reactions include:

  • Peripheral edema
  • Headache
  • Flushing
  • Dizziness
  • Palpitations
  • Asthenia
  • Nausea
  • Fatigue
  • Lethargy
  • Abdominal pain
  • Somnolence
  • Constipation/ diarrhea
  • Sexual dysfunction
  • Myalgia
  • Arthralgia
  • Dry mouth
  • Insomnia
  • Nervousness
  • Abnormal dreams
  • Paresthesia
  • Tremor
  • Vertigo

Life-threatening adverse effects include:

  • Angioedema
  • Cardiac failure

See also:

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Amlodipine Nursing Implications [Nursing Considerations]

Amlodipine nursing implications are divided into nursing assessment, interventions, and evaluation. 

Amlodipinenursing assessment

  • Obtain comprehensive medical and family history.
  • Obtain baseline vital signs including apical pulse and ECG.
  • Assess anginal pain (onset, intensity, location, duration of pain, characteristics, aggravating and relieving factors).
  • Assess fluid volume status and signs of heart failure (such as breathing difficulty, peripheral edema, jugular vein distention, crackles).
  • Obtain baseline LFTs and RFTs.

Amlodipine nursing diagnosis

  • Acute pain (indication).
  • Risk for decreased cardiac output (indication).
  • Activity intolerance (indication).

Amlodipine nursing interventions/ actions

  • Monitor blood pressure and apical pulse. Withhold amlodipine and notify the physician if systolic blood pressure is less than 90 mmHg.
  • Monitor for adverse effects of amlodipine such as headache, dizziness, asthenia, hot flush, peripheral edema.
  • Amlodipine effect increases when administered with strong CYP3A4 (such as ketoconazole, itraconazole, ritonavir). Observe for signs of hypotension and edema in patient taking both medications.
  • Monitor blood levels of cyclosporine and tacrolimus when amlodipine is co-administered. Because this may increase plasma levels of those drugs and dose adjustments are needed.
  •  Closely monitor patients with severe obstructive coronary artery disease for worsening of angina and sudden onset of myocardial infarction at the beginning and increasing dosage during amlodipine therapy.
  • Observe for symptomatic hypotension in patient with severe aortic stenosis.
  • Teach the patient how to monitor blood pressure and pulse at home.


Evaluate the effectiveness of amlodipine:

  • For reduced blood pressure within desired limits.
  • For reduced anginal pain.
  • For improved activity tolerance.
  • For absence of side effects.
  • For adherence to treatment regimen.

Pregnancy/breastfeeding considerations for amlodipine

  • It is unknown whether amlodipine can harm the fetus. Use only after consulting with physician during pregnancy.
  • It is unknown whether amlodipine excretes in the breastmilk. Consult a doctor before starting lactation.

What is the patient teaching for amlodipine?

The nursing patient teaching for amlodipine should include the following points.

  • Instruct the patient/family take medicine as prescribed and not to stop amlodipine abruptly or when feeling better.
  • Tell patient to take amlodipine with food to avoid GI upset.
  • Emphasis on the importance of adhering to treatment regimen to control blood pressure as well as modifying lifestyle (e.g., diet, exercise, smoking cessation, stress reduction).
  • Teach the patient adverse effects of amlodipine and when to notify the prescriber.
  • Advice patient to check blood pressure regularly and to keep a record.
  • Instruct the patient to change position slowly to avoid orthostatic hypotension.
  • Advise the patient to avoid hazardous activities that require alertness and motor skills until the drug’s response is established.
  • Instruct patient to avoid OTC medicine without physician’s direction.

Treatment of Overdose

  • Defibrillation
  • Beta agonists
  • IV calcium inotropic agents
  • Diuretics
  • Atropine for AV block
  • Vasopressor for hypotension
  • Active cardiac and respiratory monitoring.
  • Monitor urine output and fluid status.
  • Provide cardiovascular support.

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You learned about amlodipine nursing implications and patient teaching in this article. In addition, you’ve learned about amlodipine’s mechanism of action, pharmacokinetics, dosage, indications, contraindications, and side effects.

Recommended Readings & Reference

FDA Norvasc (Amlodipine Besylate) information

FDA Katerzia (amlodipine) information

Kee, J., Hayes, E., & McCuistion, L. (2015). PHARMACOLOGY A Patient-Centered Nursing Process Approach (8th ed.). Elsevier Inc/Saunders.

Kizior, R., & Hodgson, K. (2021). SAUNDERS NURSING DRUG HANDBOOK 2021. Elsevier Inc.

Jones & Bartlett Learning. (2021). Nurse’s Drug Handbook (20th ed.). Jones & Bartlett Learning, LLC.

Skidmore-Roth, L. (2021). MOSBY’S 2021 NURSING DRUG REFERENCE (34th ed.). Elsevier Inc.

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