Norfan (Amlodipine)

• Amlodipine is a calcium channel blocker used to manage cardiovascular conditions.
• Hypertension: reduces systolic and diastolic blood pressure, decreasing risk of stroke and heart attack.
• Chronic stable angina: improves exercise tolerance and lessens frequency of angina attacks.
• Coronary artery disease: used as part of anti‑anginal therapy to prevent ischemic episodes.

• Amlodipine selectively inhibits L‑type calcium channels in vascular smooth muscle and cardiac myocytes. By blocking calcium influx, it induces arterial vasodilation, lowers peripheral vascular resistance, and reduces myocardial oxygen demand, resulting in decreased blood pressure and relief of anginal symptoms.

Amlodipine may cause a range of adverse reactions.

Common Side Effects

• Headache: mild to moderate intensity, often transient.
• Peripheral edema: swelling of ankles or lower legs.
• Flushing: warm sensation with reddening of skin.
• Dizziness: especially upon standing quickly.
• Fatigue: general feeling of tiredness.
• Palpitations: awareness of heartbeat.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure requiring medical attention.
• Myocardial infarction: rare occurrence of heart attack.
• Arrhythmias: abnormal heart rhythms, including ventricular tachycardia.
• Hepatic enzyme elevation: significant increase in liver function tests.
• Anaphylaxis or severe allergic reaction: rapid onset of swelling, rash, and breathing difficulty.
• Stevens‑Johnson syndrome: rare skin and mucous membrane disorder.

Before initiating therapy, certain precautions should be considered.

• Blood pressure monitoring: ensure adequate control and avoid excessive drops.
• Hepatic impairment: use with caution and consider dose adjustment.
• Heart failure: assess severity; avoid abrupt discontinuation.
• Concomitant antihypertensives: monitor for additive hypotensive effects.
• Drug interactions: review patient medication list for potential interactions.
• Store at room temperature: keep in the original pack, protect from moisture and light.

Amlodipine may interact with several medicines, requiring attention to the level of risk.

Major Interactions (Avoid)

• Simvastatin: increased risk of myopathy.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may raise amlodipine plasma levels.
• Grapefruit juice: can elevate drug concentration.
• Other antihypertensives: additive blood pressure lowering effect.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampin): may reduce amlodipine effectiveness.
• Diuretics: may increase risk of electrolyte imbalance.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may blunt antihypertensive response.