Norvasc (amlodipine besylate) is a type of medication known as a calcium channel blocker. This class of medication contains compounds that relax blood vessels and decrease blood pressure. This makes it easier for your heart to pump blood throughout the body.
As important as Norvasc is in treating hypertension (high blood pressure) and angina (heart-related chest pain), it can cause side effects. One of the most common is the swelling of the ankles caused by the accumulation of fluids in tissues.
Jan-Otto / Getty ImagesThis article explains why ankle swelling occurs in people who take Norvasc and what can be done to relieve this common but frustrating side effect.
Edema, or the abnormal swelling of tissues caused by the accumulation of fluids, is a common side effect of calcium channel blockers, especially Norvasc. It typically involves the ankles and feet due to gravity but can also affect the hands and lower legs.
The risk is largely dose-dependent, meaning that higher doses correspond to a greater likeliness (or the worsening) of symptoms.
Other side effects of Norvasc include headaches, lightheadedness, fainting spells, dizziness, an irregular heartbeat, chest pain, or palpitations.
Edema, the abnormal swelling of tissues due to fluid accumulation, is a common side effect of Norvasc. The ankles and feet are most commonly affected, but the hands and lower legs may also be involved.
Edema commonly occurs with calcium channel blockers because the drugs trigger the dilation of blood vessels. The dilation, in turn, lowers the blood pressure and improves the flow of blood throughout the body.
However, the improved blood flow can increase the pressure within smaller blood vessels called capillaries. This can cause fluids to seep through the walls of the vessels into surrounding tissues.
Edema can occur with all calcium channel blockers.
Norvasc helps lower blood pressure by triggering the dilation of blood vessels. The increased blood flow, in turn, intensifies the pressure within smaller blood vessels, causing excess fluids to seep through the walls of the vessels into surrounding tissues.
If you experience edema while taking Norvasc, do not stop treatment until you speak with your healthcare provider. In some cases, you may be placed on a diuretic ("water pill") to reduce the swelling. Or, the Norvasc dose may be reduced.
If symptoms persist, your healthcare provider may switch you to another calcium channel blocker or another class of blood pressure medications.
It is important to note that ankle swelling is also a symptom of heart failure and pulmonary hypertension. As such, Norvasc may not be the cause of edema but simply contribute to its development. Your healthcare provider may want to perform additional tests to rule out these conditions before changing treatment.
If you experience edema while on Norvasc, your healthcare provider may opt to reduce the dose or change you to another calcium channel blocker or an entirely different class of blood pressure medication.
Norvasc is available as a tablet and formulated in doses of 2.5, 5, and 10 milligrams (mg). The standard recommended dose is 5 mg once daily, increasing to a maximum dose is 10 mg once daily if needed.
People who are smaller, elderly, or have liver problems should be started on a 2.5-mg dose and increased gradually to obtain the desired response.
Never exceed the recommended daily dose. It is possible to overdose on calcium-channel blockers, leading to potentially serious side effects, such as:
- Constipation
- Confusion
- Drowsiness
- Slowed heartbeat
- Slurred speech
- Shortness of breath
- Weakness
- Nausea
- Increased blood sugar
If an overdose is suspected, call the Poison Control Hotline at 1-800-222-1222, available 24 hours sevens days a week. Do not induce vomiting unless a trained poison control professional tells you to do so.
For most adults, the recommended dose of Norvasc is 5 mg once daily, increasing to a maximum dose is 10 mg once daily if needed. Do not exceed the recommended dose.
Norvasc (amlodipine besylate) is a type of drug called a calcium channel blocker used to treat high blood pressure and angina. One of the more common side effects of Norvasc is edema, or the abnormal swelling of tissue due to the build-up of fluid. Although the ankles and feet are most commonly affected, the hands and lower legs may also experience swelling.
Calcium channel blockers like Norvasc help lower blood pressure by dilating blood vessels. The increased blood flow, in turn, intensifies the pressure within smaller blood vessels, causing fluids to leak through the walls of the vessels into surrounding tissues.
If edema occurs while taking Norvasc, call your healthcare provider. You may be switch to another calcium channel blocker or a different class of blood pressure medication. Or, the Norvasc dose may simply be reduced to see if that helps. Never stop or alter treatment without first speaking to your healthcare provider.
Edema can be a worrisome and frustrating side effect of Norvasc. But, on its own, edema is not a reason to stop treatment. Even if your healthcare provider cannot fully resolve the swelling, the benefits of medications like Norvasc generally outweigh the risks.
This doesn't mean, however, that you should ignore the side effect or "just live with it." By exercising regularly, eating a healthy diet, and maintaining your ideal weight, you may be able to minimize or alleviate the symptoms of edema caused by Norvasc.
The most likely reason to be started on amlodipine is for blood pressure control. It causes relaxation and dilation of the blood vessels leading to lowering of blood pressure. The other reason people are started on amlodipine is for control of chest pain in people with coronary artery disease, amlodipine is thought to achieve this effect by decreasing the amount of work the heart has to do with each beat. Although most people won’t experience amlodipine side effects, it is important to be aware of them as in some cases, amlodipine side effects will require them to discontinue the medication.
The Most Common – Ankle Swelling
Swelling is the most common of amlodipine side effects, usually manifesting as swelling of the feet and ankles. If we look at clinical trial studies of amlodipine that looked at thousands of patients, the number of people experiencing swelling appears to be related to the dose taken. In those taking low dose (2.5mg) amlodipine, about 2 people in every 100 taking the drug reported leg swelling (2%). In those taking higher dose (10mg) amlodipine, about 10 people in every 100 reported leg swelling (10%). Interestingly, women are more likely to get the swelling, and most people tolerate this well and do not have to discontinue the medication.
Less Common Side Effects – Fatigue and Flushing
Less common amlodipine side effects are fatigue and flushing. In studies of amlodipine fatigue was reported in 5% of people taking the drug. Interestingly 3% of people taking a sugar pill (placebo) in the same studies reported fatigue also. Flushing is slightly less common. At the low doses such as 2.5mg, less than 1% of people report flushing, however at higher doses up to 3% of people report flushing, and this is more common in women. The number of people reporting palpitations is similar. Abdominal pain is reported even less frequently. The decision as to whether to stop the medication due to these amlodipine side effects should be determined with the prescribing doctor on a case-by-case basis.
Uncommon And Rare Side Effects
There is a long list of amlodipine side effects that occur in less than 1 in 100 people taking the medication and an even longer list that occur in less than 1 in 1000 people taking the complication. These include allergic reactions, shortness of breath, itching and cramps. Clicking on the following link will take you to the FDA prescribing information for amlodipine that contains this long list of uncommon and rare amlodipine side effects and details about other studies of the drug.
What To Do If You Think You Have A Side Effect
As can be seen on many Internet message boards, given the fact amlodipine is such a highly prescribed medication, there will always be people that have, or are concerned they have a side effect. Of course in some cases, the people will tolerate these amlodipine effects more than others. In every case of concern this should be discussed with the prescribing doctor. If the side effect is troublesome, the only way to know for sure if amlodipine is causing the symptoms is to have a trial of stopping the medication. Fortunately amlodipine side effects are not common. Also amlodipine is not generally prescribed on an emergency basis, and alternatives are often available, so if the patient decides with the help of their doctor to stop the medication and try an alternative it is not usually a critical issue.
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