Krudipin (Amlodipine)

Amlodipine is used to manage conditions related to elevated vascular tone and coronary artery disease.

• Hypertension: Reduces systolic and diastolic blood pressure, decreasing risk of stroke and heart failure.
• Chronic stable angina: Improves exercise tolerance by preventing coronary vasospasm and reducing myocardial oxygen demand.
• Coronary artery disease: Lowers incidence of ischemic events through sustained vasodilation of coronary vessels.

• Amlodipine selectively inhibits L‑type calcium channels in vascular smooth muscle and cardiac myocytes. By blocking calcium influx, it prevents contraction of arterial smooth muscle, producing arterial vasodilation and reducing peripheral vascular resistance. In the heart, it modestly decreases afterload without significantly affecting heart rate, contributing to lowered blood pressure and improved myocardial oxygen balance. The prolonged half‑life allows once‑daily dosing and maintains steady plasma concentrations.

Amlodipine may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Headache: mild to moderate intensity, often transient.
• Peripheral edema: swelling of ankles or feet due to fluid accumulation.
• Flushing: warm sensation and reddening of skin.
• Dizziness: especially when standing quickly.
• Fatigue: general feeling of tiredness.

Serious or Rare Side Effects

• Hypotension: marked drop in blood pressure leading to fainting.
• Myocardial infarction: rare occurrence of heart attack.
• Severe allergic reaction: rash, itching, swelling, or difficulty breathing.
• Hepatotoxicity: abnormal liver function tests.
• Arrhythmia: irregular heart rhythm.

Before prescribing amlodipine, clinicians should consider several safety considerations.

• Blood pressure monitoring: Check baseline and periodic readings to avoid excessive hypotension.
• Cardiac function: Use cautiously in patients with severe heart failure or recent myocardial infarction.
• Liver impairment: Dose adjustment may be needed in moderate to severe hepatic dysfunction.
• Pregnancy and lactation: Use only if potential benefit justifies risk, as safety data are limited.
• Drug interactions: Review concomitant medications for possible additive blood pressure effects.
• Store at ambient temperature: Keep below 25 °C, in original packaging, protected from moisture and light.

Amlodipine can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Simultaneous use with strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may increase amlodipine levels and risk of hypotension.
• Co‑administration with other potent antihypertensives (e.g., beta‑blockers, ACE inhibitors) without monitoring: can cause excessive blood pressure drop.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampicin, phenytoin): may reduce amlodipine concentrations, diminishing effect.
• Grapefruit juice: can modestly increase plasma levels.
• Diuretics: may enhance orthostatic hypotension.
• Lithium: may increase serum lithium levels.
• NSAIDs: may attenuate antihypertensive effect.