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# Mylod (Amlodipine)
## Overview
Amlodipine is a long-acting dihydropyridine calcium channel blocker (CCB) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle, resulting in peripheral vasodilation and reduced blood pressure.
## Primary Indications
* Hypertension
* Chronic stable angina
* Vasospastic (Prinzmetal’s) angina
## Adult Dosing
* **Hypertension:** Initial: 5 mg once daily. Maintenance: 5–10 mg once daily. Maximum: 10 mg/day.
* **Angina:** 5–10 mg once daily. Most patients require 10 mg for adequate effect.
## Pediatric Dosing
* **Hypertension (≥6 years):** 2.5–5 mg once daily. Doses >5 mg/day have not been studied in children.
## Dose Adjustments
* **Hepatic Impairment:** Reduce starting dose to 2.5 mg once daily; titrate slowly.
* **Renal Impairment:** No dosage adjustment necessary.
* **Geriatric/Small patients:** Consider starting at 2.5 mg once daily.
## Contraindications
* Known hypersensitivity to amlodipine or other dihydropyridines.
## Adverse Effects
* **Common:** Peripheral edema (dose-dependent), dizziness, flushing, palpitations, fatigue.
* **Serious:** Hypotension, worsening angina or myocardial infarction (rarely upon initiation or dose increase).
## Key Drug Interactions
* **Simvastatin:** Limit simvastatin dose to 20 mg/day when co-administered with amlodipine (increased statin exposure).
* **CYP3A4 Inhibitors/Inducers:** Monitor for altered efficacy or increased side effects.
* **Cyclosporine/Tacrolimus:** Amlodipine may increase blood levels of these immunosuppressants.
## Monitoring
* Blood pressure (at trough levels).
* Heart rate (less significant than non-dihydropyridines, but monitor for reflex tachycardia).
* Presence of peripheral edema.
## Clinical Pearls
* **Half-life:** Long elimination half-life (30–50 hours) allows for once-daily dosing and minimal rebound hypertension if a dose is missed.
* **Edema:** Peripheral edema is often not responsive to diuretics; may require dose reduction or combination therapy with an ACE inhibitor/ARB.
* **Administration:** May be taken without regard to meals.
* **Onset:** Full antihypertensive effect may take up to 2 weeks to manifest.
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**Educational Disclaimer:** This information is for educational purposes only. Clinical practice protocols vary by institution. Always verify current prescribing information, contraindications, and drug interactions via official resources (e.g., package insert, Lexicomp, or UpToDate) before prescribing or administering medication.
