Amlodipine Besylate

Sign in to Print/View PDF

Amlodipine Besylate

Calcium Channel Blocker (Systemic Drug)

Prescriber Highlights

  • Dihydropyridine calcium channel blocker is often used for treating hypertension, especially in cats
  • Use with caution in patients with heart disease and hepatic dysfunction because it is a slight negative inotrope
  • Hypertension can reoccur rapidly if doses are missed
  • Has the potential to cause anorexia and hypotension in cats, and gingival hyperplasia in dogs
Uses, Indications
  • The treatment of choice for cats with hypertension, according to the International Society of Feline Medicine
  • Can lower blood pressure in dogs with hypertension secondary to renal disease; however, efficacy in lowering blood pressure in dogs due to other causes is not well established
Precautions, Warnings
  • Precautions
    • Patients with heart failure, cardiogenic shock, or hepatic disease, because amlodipine is a slight negative inotrope
    • Use cautiously in patients at risk of hypotension
  • Warnings
    • Not recommended for dogs with pulmonary hypertension because systemic hypotension can occur
    • Shown to activate renin-angiotensin-aldosterone system (RAAS) when used alone in healthy dogs at higher doses
      • Use of amlodipine combined with ACE inhibitors may partially block this effect but routine use together is controversial
Side Effects
  • Hypotension, bradycardia, and inappetence
  • Cats may develop azotemia, lethargy, hypokalemia, reflex tachycardia, and weight loss
  • Dogs may develop reversible gingival hyperplasia
  • Diffuse peripheral edema has been reported in dogs 

Article continues after advertisement

Drug Interactions
  • May decrease the antithrombotic effect of clopidogrel
  • May increase cyclosporine and tacrolimus levels
  • Amlodipine levels may be increased with CYP3A4 inhibitors (eg, ketoconazole, itraconazole)
  • Amlodipine levels may be decreased with CYP3A4 inducers (eg, rifampin)
  • Other drugs causing decreased blood pressure may have an additive effect
Monitoring
  • Blood pressure (ie, maintaining systolic blood pressure less than 160mmHg) is recommended in cats
  • Fundic examinations
  • Potassium levels, especially in cats with chronic kidney disease
Client Information
  • May be given with or without food
  • Not skipping doses is very important because hypertension can quickly reoccur
  • Side effects are uncommon, but can include reduced appetite and low blood pressure, especially early in treatment
  • In dogs, overgrowth of the gums can occur
  • Patients will need frequent rechecks with the veterinarian to ensure the medication is working properly 
Dosage Forms
  • Amlodipine oral tablets: 2.5 mg, 5 mg, 10 mg tablets

Compiled and summarized from Plumb’s® Veterinary Drugs by Shannon Palermo, VMD

Information about this drug was adapted from Plumb’s® Veterinary Drugs. Further details and more therapeutics can be found with a subscription at plumbsveterinarydrugs.com

Material from Veterinary Team Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Practice Tools

Topic

Clinical

Veterinary Team Brief delivers practical skills for team-based medicine—with clinical strategies for team training, peer-reviewed credibility, concise content, essential training modules, and easy-to-implement protocols. From the publisher of Clinician's Brief.

© 2018 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Privacy Policy (Updated 05/08/2018) Terms of Use (Updated 05/08/2018)