Mylod%2525252525252525252525252525252525252525252520at

# Mylod (Amlodipine) ## Overview Amlodipine is a long-acting dihydropyridine calcium channel blocker (CCB). It inhibits transmembrane calcium influx into vascular smooth muscle and cardiac muscle, resulting in peripheral vasodilation and reduced blood pressure. ## Primary Indications Hypertension, chronic stable angina, and vasospastic (Prinzmetal's) angina. ## Adult Dosing * **Initial Dose:** 5 mg orally once daily. * **Maximum Dose:** 10 mg orally once daily. * **Titration:** Adjust dose based on blood pressure response, typically at intervals of no less than 7–14 days. ## Pediatric Dosing * **Hypertension (Age 6–17 years):** 2.5 mg to 5 mg orally once daily. * **Maximum Dose:** 5 mg once daily. * *Note:* Efficacy in children younger than 6 years has not been established. ## Dose Adjustments * **Hepatic Impairment:** Start at 2.5 mg daily. Amlodipine is extensively metabolized by the liver; use caution and monitor blood pressure closely. * **Renal Impairment:** No dosage adjustment is required for patients with renal failure. ## Contraindications Known hypersensitivity to amlodipine or other dihydropyridines. ## Adverse Effects * **Common:** Peripheral edema (dose-dependent), dizziness, flushing, fatigue, and palpitations. * **Rare:** Gingival hyperplasia, hypotension, and increased frequency or severity of angina upon initiation or dose increase. ## Key Drug Interactions * **CYP3A4 Inhibitors:** Moderate to strong inhibitors (e.g., clarithromycin, ketoconazole, ritonavir) may increase amlodipine plasma concentrations. * **Simvastatin:** Limit simvastatin dose to 20 mg daily when co-administered with amlodipine to reduce risk of myopathy. * **Cyclosporine/Tacrolimus:** Amlodipine may increase serum levels of these calcineurin inhibitors. ## Monitoring * **Blood Pressure:** Monitor regular readings for efficacy. * **Peripheral Edema:** Assess for development of dependent edema, which may be mistaken for clinical heart failure. ## Clinical Pearls * **Onset:** Amlodipine has a slow onset of action; it is not indicated for the acute treatment of hypertensive urgency or emergency. * **Edema:** Peripheral edema is not due to fluid retention and generally does not respond well to diuretics; consider dose reduction or switching to an ACE inhibitor or ARB if severe. * **Administration:** May be taken without regard to meals. Tablets should not be split unless specified by the manufacturer's formulation. *** *Disclaimer: This information is for educational purposes only. Always verify drug dosages, contraindications, and potential interactions against the most current institutional guidelines and FDA-approved prescribing information before making clinical decisions.*