If you’ve recently been prescribed amlodipine (brand name Norvasc)—a drug commonly used to treat high blood pressure—you probably have some questions. We’re here to separate fact from fiction and answer some of the most common questions about amlodipine.
Amlodipine is a calcium channel blocker that is commonly prescribed to treat high blood pressure (hypertension) and coronary artery disease. It works by relaxing blood vessels so blood can flow more easily. While amlodipine is generally considered safe and effective, some people decide to stop taking it, with or without their doctor’s supervision. This raises the question: is it safe to stop amlodipine cold turkey?
How Amlodipine Works
When calcium channels in artery walls are blocked by amlodipine, the arteries relax and widen. This lowers blood pressure. Amlodipine also improves blood flow to the heart in people with coronary artery disease. It does this by widening the arteries supplying blood to the heart
Amlodipine belongs to a class of medications called calcium channel blockers. Other drugs in this class include diltiazem (Cardizem) nicardipine (Cardene) nifedipine (Procardia), and verapamil (Calan).
Why People Stop Taking Amlodipine
There are several reasons why someone might want to stop taking amlodipine:
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Bothersome side effects. Common side effects of amlodipine include headache, fatigue, dizziness, edema (swelling), flushing, nausea, and rash. For some people, the side effects outweigh the benefits of the medication.
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Feeling better. If lifestyle changes like diet, exercise, and stress management lower blood pressure enough, some people may feel they no longer need the medication.
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Doctor supervision no longer needed. After being on amlodipine for some time, a person’s doctor may decide they can stop taking it if their blood pressure remains controlled.
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Wanting to try alternative therapies. Some people prefer to use herbal remedies, supplements, or lifestyle changes to control their blood pressure and may want to stop taking amlodipine as a result.
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Access and affordability issues. Amlodipine is available as a relatively inexpensive generic medicine. But for some people without prescription drug coverage, even generic amlodipine may be too costly.
Dangers of Stopping Amlodipine Suddenly
While amlodipine is generally safe when taken as prescribed, there are risks associated with stopping the medication abruptly. Potential complications include:
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Rebound hypertension. Blood pressure may spike higher than it was before the person started taking amlodipine. This is known as rebound or withdrawal hypertension.
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Irregular heart rhythms. Amlodipine helps control heart rate. Abruptly stopping it may trigger an abnormal heart rhythm called an arrhythmia.
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Angina. If amlodipine was prescribed for coronary artery disease, angina (chest pain) may worsen after sudden discontinuation.
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Stroke. The rapid blood pressure increase after quitting amlodipine without tapering could lead to a stroke. This risk may be greater if the person already has severe hypertension.
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Heart attack. For those with coronary artery disease, the heightened stress on the heart after stopping amlodipine may trigger a heart attack.
While these potentially life-threatening heart problems are rare, medical professionals urge caution when discontinuing amlodipine or any blood pressure medication.
Tapering Amlodipine Under Medical Supervision
To avoid complications, doctors recommend patients taper amlodipine slowly under medical supervision. This may involve gradually decreasing the dosage over several weeks or more. For example:
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If the starting dose is 10 mg per day, taper by taking 5 mg daily for 1 to 2 weeks.
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Then switch to 5 mg every other day for 1 to 2 weeks.
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Finally, stop taking it altogether and closely monitor blood pressure.
This gradual weaning reduces the likelihood of rebound hypertension and other problems. Frequency of doctor visits and blood pressure checks may increase during the tapering process.
For some patients, the doctor may recommend switching to another medication first before tapering amlodipine. This provides continued blood pressure control while safely transitioning to an alternative therapy.
Precautions With Amlodipine Cessation
Doctors stress that no one should stop taking amlodipine or any blood pressure medication on their own without first consulting their physician. However, a person who has already stopped amlodipine abruptly should take these precautions:
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Carefully monitor blood pressure with a home monitor. Check it twice per day or as directed by your physician.
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Watch for potential medication withdrawal symptoms like chest pain, irregular heart rate, severe headache, shortness of breath, and dizziness.
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Be prepared to restart amlodipine or another medication if blood pressure remains very high or concerning symptoms develop.
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Seek prompt medical attention if experiencing signs of stroke, heart attack, or other emergency conditions.
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Avoid driving or hazardous activities in the days after quitting amlodipine until any blood pressure fluctuations have stabilized.
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Follow up promptly with your healthcare provider, even if feeling well. They need to reassess your condition.
The Takeaway
While amlodipine is generally safe, stopping it abruptly can be dangerous in some cases. To avoid complications, amlodipine should always be tapered gradually under a doctor’s supervision. Anyone who has already stopped amlodipine cold turkey needs prompt medical follow up. With proper monitoring, most people can safely discontinue amlodipine use when medically appropriate.
Is amlodipine a beta blocker?
No, amlodipine is not a beta blocker—it’s a calcium channel blocker. Both drugs have a similar effect on blood pressure but different mechanisms of action.
“Beta blockers affect heart rate and how fast the heart beats,” says Jennifer Wong, MD, cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California. “Calcium channel blockers have vasodilating effects that help the smooth muscles of the arteries dilate and lower your blood pressure.”
What are the dangers of taking amlodipine?
In general, amlodipine is considered a safe and effective antihypertensive drug when taken at the correct dosage. It’s been prescribed widely for over 20 years, per a 2016 research article in Open Heart. That means we have a strong body of evidence for its use in treating hypertension and angina. Controlling blood pressure helps to reduce your risk of medical conditions including heart attack, heart disease, and stroke.
That said, amlodipine can be dangerous when taken in excessive amounts. It’s a common cause of drug overdose in cardiovascular medicine and its toxicity can be fatal, but it’s important to note that several reported cases of amlodipine overdose involved extremely high amounts of the drug (i.e., 50 or more tablets). If you think you took too much amlodipine, call Poison Control at 1-800-222-1222 or get emergency medical help. Symptoms of an amlodipine overdose may include fast heartbeat, fainting, and/or redness and warmth in the arms and legs.
In typical dosages, amlodipine can cause arterial dilation, says Dr. Wong, which can lead to swelling in the legs, excess amounts of blood pooling or collecting in the veins, dizziness, headaches, and flushing.
Though many people believe amlodipine can cause weight gain, that hasn’t been widely seen in studies or trials; it may happen in less than 1% of people taking it. The edema and swelling that amlodipine can cause may also make it seem as though the drug leads to weight gain.
Talk to your healthcare provider if you’re considering using amlodipine during pregnancy or while breastfeeding.