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# Mylod (Amlodipine)
## Overview
Amlodipine is a long-acting dihydropyridine calcium channel blocker (CCB). It inhibits transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle, resulting in peripheral arterial vasodilation and reduced blood pressure.
## Primary Indications
* Hypertension
* Chronic stable angina
* Vasospastic (Prinzmetal’s) angina
## Adult Dosing
* **Hypertension:** Initial: 5 mg once daily. Max: 10 mg once daily.
* **Angina:** Initial: 5 mg once daily. Max: 10 mg once daily.
* **Geriatric/Hepatic Impairment:** Initial: 2.5 mg once daily.
## Pediatric Dosing
* **Hypertension (≥6 years):** 2.5 mg to 5 mg once daily. Doses >5 mg daily have not been studied in pediatric patients.
## Dose Adjustments
* **Renal Impairment:** No dose adjustment required.
* **Hepatic Impairment:** Initiate at 2.5 mg; monitor closely as amlodipine is extensively metabolized by the liver and half-life is prolonged.
## Contraindications
* Known hypersensitivity to amlodipine.
## Adverse Effects
* **Common:** Peripheral edema (dose-dependent, more common in women), dizziness, palpitations, flushing, fatigue.
* **Rare:** Gingival hyperplasia, orthostatic hypotension, worsening of angina (upon initiation or dose increase).
## Key Drug Interactions
* **Simvastatin:** Limit simvastatin to 20 mg daily when co-administered with amlodipine to reduce risk of myopathy.
* **CYP3A4 Inhibitors/Inducers:** Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) may increase amlodipine concentration; inducers (e.g., rifampin) may decrease it.
* **Cyclosporine/Tacrolimus:** Amlodipine may increase serum levels of these calcineurin inhibitors.
## Monitoring
* **Blood Pressure:** Baseline and during titration.
* **Clinical:** Monitor for peripheral edema (distinct from systemic fluid overload), signs of hypotension, and frequency of angina attacks.
* **Hepatic function:** In patients with severe hepatic impairment.
## Clinical Pearls
* **Edema Management:** Peripheral edema is "non-pitting" and caused by precapillary vasodilation; it often does not respond well to diuretics. If severe, consider switching to another antihypertensive class or reducing the dose.
* **Half-life:** Amlodipine has a long elimination half-life (30–50 hours), allowing for once-daily dosing. Missed doses are less likely to lead to rebound hypertension compared to other CCBs.
* **Administration:** May be taken without regard to meals.
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*Disclaimer: This information is for educational purposes only. Clinical practice protocols vary. Always verify current prescribing information, contraindications, and drug-drug interactions via official institutional resources or the product package insert before prescribing or administering medication.*
