AMLODIPINE BESYLATE 10 mg Tablet, 10-count
🆔 Identity & classification
Where does this data come from?
🏷️ RxNorm drug class
This medicine belongs to the Dihydropyridine Calcium Channel Blocker class.
Where does this data come from?
🏭 Manufacturer & labeler
Where does this data come from?
🩺 Clinical
- Amlodipine is used mainly to treat two things: high blood pressure and certain types of chest pain (angina). For high blood pressure, it's approved for adults and children as young...
- The most common one is swelling in your ankles or legs — this is dose-related, so it's more noticeable at higher doses, and women tend to notice it more than men. Dizziness, flushi...
- What side effects should I expect, and which ones should I call about?
- You can take amlodipine with or without food — it doesn't make a meaningful difference in how well it's absorbed. Because it stays in your system for a long time (a half-life of 30...
Patient education
Supplement & herbal interactions
Some supplements/herbs that may interact with Amlodipine Besylate — tap one for details:
Amlodipine Besylate may be associated with lower levels of 2 nutrients — worth a chat with your pharmacist, not a cause for alarm.
Where does this data come from?
Ask a licensed pharmacist directly — free, answered by our team.
💊 What it looks like
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🧪 Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.
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UNII O7TSZ97GEP
A mineral compound that serves as a filler and binding agent in tablets and capsules. It adds bulk to the medicine and helps hold ingredients together during manufacturing.
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UNII 70097M6I30
Magnesium stearate is a salt made from magnesium and stearic acid, a fatty substance. It's used in tablets and capsules as a lubricant and glidant to help ingredients flow smoothly during manufacturing and prevent sticking.
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UNII OP1R32D61U
Microcrystalline cellulose is a purified form of cellulose, a natural fiber from plant sources. It acts as a binder and filler in tablets and capsules, helping hold ingredients together and give the medicine its shape and size.
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UNII ETJ7Z6XBU4
Silicon dioxide is a naturally occurring mineral used as a glidant and anti-caking agent. It helps powder ingredients flow smoothly and prevents clumping during manufacturing and storage.
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UNII 5856J3G2A2
A starch-based powder made from potatoes and processed with sodium. It acts as a disintegrant, helping the tablet or capsule break apart quickly in the stomach so the medicine can be absorbed.
5 inactive ingredients listed in the exact product block matched to this NDC.
Where does this data come from?
ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
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Can inactive ingredients matter?
💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per each | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data. | |
| Medicare drug plans payPart D · Q2 2026 | $0.0799 | $0.80 / 10 tablets |
Where does this data come from?
🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Amlodipine Besylate 10 mg 00480-7168-98 | Teva | 90 tablets | $0.015 | AB | Discontinued | — |
| Amlodipine Besylate 10 mg 00904-6371-61 | Major | 100 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 29300-0398-05 | Unichem | 500 tablets | $0.015 | AB | Availability likely | — |
| amlodipine besylate 10 mg 59762-2135-01 | Mylan | 1000 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 60687-0496-01 | American | 100 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 67877-0199-05 | Ascend | 500 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 67877-0902-10 | Ascend | 1000 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 68180-0721-03 | Lupin | 1000 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 68645-0516-54 | Legacy | 30 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 68645-0580-54 | Legacy | 30 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 69097-0128-05 | Cipla | 90 tablets | $0.015 | AB | Availability likely | — |
| AMLODIPINE BESYLATE 10 mg 69584-0023-09 | Oxford | 90 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 82009-0028-10 | Quallent | 1000 tablets | $0.015 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 42806-0057-05 | Epic | 500 tablets | $0.017 | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 69097-0838-05 | Cipla | 90 tablets | $0.019 | AB | FDA listed | — |
| Norvasc 10 mg 00069-1540-41 | PFIZER | 100 tablets | $11.190 | AB | Discontinued | — |
| Norvasc 10 mg 58151-0355-77 | Viatris | 90 tablets | $11.976 | AB | Availability likely | — |
| Amlodipine Besylate 10 mg 00615-8431-05 | NCS | 15 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 42291-0027-10 | AvKARE | 1000 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 43063-0041-30 | PD-Rx | 30 tablets | — | AB | FDA listed | — |
| Amlodipine besylate 10 mg 43353-0989-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 43489-0101-01 | China | 90 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 48433-0157-20 | Safecor | 100 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 50090-2581-00 | A-S | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 50090-5354-00 | A-S | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 50090-5355-00 | A-S | 90 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 50090-5550-00 | A-S | 90 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 50090-6808-00 | A-S | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 50090-6809-00 | A-S | 90 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 51407-0951-10 | GSMS, | 1000 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 51655-0586-52 | Northwind | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 51655-0869-52 | Northwind | 30 tablets | — | AB | FDA listed | — |
| amlodipine besylate 10 mg 52605-0043-10 | POLYGEN | 1000 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 55154-6875-00 | Cardinal | 10 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 60760-0445-30 | ST. | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 63187-0914-30 | Proficient | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 65841-0622-01 | Zydus | 100 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 65862-0103-05 | Aurobindo | 500 tablets | — | — | FDA listed | — |
| Amlodipine Besylate 10 mg 68071-2305-02 | NuCare | 120 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 68071-2520-09 | NuCare | 90 tablets | — | AB | FDA listed | — |
| AMLODIPINE BESYLATE 10 mg 68071-3453-02 | NuCare | 120 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 68071-3698-02 | NuCare | 120 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 68382-0123-01 | Zydus | 100 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 68788-4085-01 | Preferred | 100 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 68788-7985-01 | Preferred | 100 tablets | — | AB | FDA listed | — |
| AMLODIPINE BESYLATE 10 mg 68788-8451-01 | Preferred | 100 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 68788-8543-01 | Preferred | 100 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 70518-0297-00 | REMEDYREPACK | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 70518-2632-00 | REMEDYREPACK | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 70518-4464-00 | REMEDYREPACK | 90 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71205-0488-30 | Proficient | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71205-0506-30 | Proficient | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mgthis 71335-0218-09 | Bryant | 10 tablets | — | AB | FDA listed | — |
| Amlodipine besylate 10 mg 71335-0843-01 | Bryant | 30 tablets | — | AB | Discontinued | — |
| Amlodipine Besylate 10 mg 71335-0945-01 | Bryant | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71335-1865-01 | Bryant | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71335-1887-01 | Bryant | 30 tablets | — | — | Discontinued | — |
| Amlodipine Besylate 10 mg 71335-2507-00 | Bryant | 7 tablets | — | AB | FDA listed | — |
| amlodipine besylate 10 mg 71610-0469-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71610-0620-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| AMLODIPINE BESYLATE 10 mg 71610-0830-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71610-0928-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71610-0938-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| AMLODIPINE BESYLATE 10 mg 71610-0978-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 71610-0988-30 | Aphena | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 72189-0529-90 | Direct_Rx | 90 tablets | — | AB | FDA listed | — |
| AMLODIPINE BESYLATE 10 mg 72789-0262-90 | PD-Rx | 90 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 72789-0516-30 | PD-Rx | 30 tablets | — | AB | FDA listed | — |
| Amlodipine besylate 10 mg 76282-0239-05 | Exelan | 500 tablets | — | AB | FDA listed | — |
| Amlodipine besylate 10 mg 76282-0509-05 | Exelan | 500 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 82804-0164-90 | Proficient | 90 tablets | — | AB | FDA listed | — |
| AMLODIPINE BESYLATE 10 mg 82804-0971-00 | Proficient | 100 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 82868-0031-90 | Northwind | 90 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 83209-0399-10 | Boswell | 10 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 87441-0016-01 | Unit | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 68071-1980-02 | NuCare | 120 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 67296-2297-03 | Redpharm | 30 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 00615-8652-05 | NCS | 15 tablets | — | AB | FDA listed | — |
| Amlodipine Besylate 10 mg 60687-0961-01 | American | 100 tablets | — | AB | FDA listed | — |
Where does this data come from?
⏳ Availability & generic status
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
Where does this data come from?
📊 Medicare Part D spend CMS · PART D · 2026 (Q1)
🔬 Reported adverse events (FAERS)
Top reported reactions
Age at onset
Reporter sex
Serious outcomes
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📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 71335-0218-01 | 30 TABLET in 1 BOTTLE (71335-0218-1) | 2018-03-30 | Active |
| 71335-0218-02 | 90 TABLET in 1 BOTTLE (71335-0218-2) | 2018-02-26 | Active |
| 71335-0218-03 | 60 TABLET in 1 BOTTLE (71335-0218-3) | 2018-03-30 | Active |
| 71335-0218-04 | 120 TABLET in 1 BOTTLE (71335-0218-4) | 2022-09-23 | Active |
| 71335-0218-05 | 100 TABLET in 1 BOTTLE (71335-0218-5) | 2022-09-23 | Active |
| 71335-0218-06 | 800 TABLET in 1 BOTTLE (71335-0218-6) | 2022-09-23 | Active |
| 71335-0218-07 | 1000 TABLET in 1 BOTTLE (71335-0218-7) | 2022-09-23 | Active |
| 71335-0218-08 | 180 TABLET in 1 BOTTLE (71335-0218-8) | 2022-09-23 | Active |
| 71335-0218-09 You're viewing this | 10 TABLET in 1 BOTTLE (71335-0218-9) | 2022-09-23 | Active |
| 71335-0218-00 | 7 TABLET in 1 BOTTLE (71335-0218-0) | 2022-09-23 | Active |
You're viewing one of 10 pack sizes for this product.
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🧭 About this NDC listing & data coverage
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| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | ✓ Available |
| Package photos | ✓ Available |
| Inactive ingredients (structured) | ✓ Available |
| NADAC pharmacy acquisition price (CMS) | — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey. |
| Orange Book / therapeutic-equivalence data | ✓ Available |
| HCPCS J-code billing crosswalk | — Not published for this NDC Most self-administered / retail products have no J-code — that is normal. |
| Medicaid utilization (CMS SDUD) | — Not published for this NDC CMS reports utilization only for NDCs with Medicaid claims above its privacy threshold. |
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📄 Full prescribing information FDA SPL
🎯 Indications and Usage ▾
1 INDICATIONS AND USAGE Amlodipine besylate tablet, USP is a calcium channel blocker and may be used alone or in combination with other antihypertensive and antianginal agents for the treatment of: • Hypertension (1.1) o Amlodipine besylate tablets are indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. • Coronary Artery Disease (1.2) o Chronic Stable Angina o Vasospastic Angina (Prinzmetal's or Variant Angina) o Angiographically Documented Coronary Artery Disease in patients without heart failure or an ejection fraction < 40%
1.1Hypertension Amlodipine besylate tablets are indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including amlodipine besylate tablet, USP.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program's Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy. Amlodipine besylate tablets may be used alone or in combination with other antihypertensive agents.
1.2Coronary Artery Disease (CAD) Chronic Stable Angina Amlodipine besylate tablets are indicated for the symptomatic treatment of chronic stable angina. Amlodipine besylate tablets may be used alone or in combination with other antianginal agents. Vasospastic Angina (Prinzmetal's or Variant Angina) Amlodipine besylate tablets are indicated for the treatment of confirmed or suspected vasospastic angina.
Amlodipine besylate tablets may be used as monotherapy or in combination with other antianginal agents. Angiographically Documented CAD In patients with recently documented CAD by angiography and without heart failure or an ejection fraction <40%, amlodipine besylate tablets are indicated to reduce the risk of hospitaliza…
⏱️ Dosage and Administration ▾
2 DOSAGE AND ADMINISTRATION • Adult recommended starting dose: 5 mg once daily with maximum dose 10 mg once daily. ( 2.1 ) o Small, fragile, or elderly patients or patients with hepatic insufficiency may be started on 2.5 mg once daily. ( 2.1 ) • Pediatric starting dose: 2.5 mg to 5 mg once daily. ( 2.2 ) Important Limitation: Doses in excess of 5 mg daily have not been studied in pediatric patients. ( 2.2 )
2.1Adults The usual initial antihypertensive oral dose of amlodipine besylate tablet is 5 mg once daily, and the maximum dose is 10 mg once daily. Small, fragile, or elderly patients, or patients with hepatic insufficiency may be started on 2.5 mg once daily and this dose may be used when adding amlodipine besylate tablet to other antihypertensive therapy. Adjust dosage according to blood pressure goals.
In general, wait 7 to 14 days between titration steps. Titrate more rapidly, however, if clinically warranted, provided the patient is assessed frequently. Angina: The recommended dose for chronic stable or vasospastic angina is 5 to 10 mg, with the lower dose suggested in the elderly and in patients with hepatic insufficiency.
Most patients will require 10 mg for adequate effect. Coronary artery disease: The recommended dose range for patients with coronary artery disease is 5 to 10 mg once daily. In clinical studies, the majority of patients required 10 mg [see Clinical Studies (14.4)].
2.2Children The effective antihypertensive oral dose in pediatric patients ages 6–17 years is 2.5 mg to 5 mg once daily. Doses in excess of 5 mg daily have not been studied in pediatric patients [see Clinical Pharmacology ( 12.4 ), Clinical Studies ( 14.1 )].
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS AND STRENGTHS • 2.5 mg, 5 mg, and 10 mg Tablets ( 3 ) Tablets: 2.5 mg, white to off white round tablets with "126" debossed on one side and "C" on other side Tablets: 5 mg, white to off white round tablets with "127" debossed on one side and "C" on other side Tablets: 10 mg, white to off white round tablets with "128" debossed on one side and "C" on other side
⛔ Contraindications ▾
4 CONTRAINDICATIONS • Known sensitivity to amlodipine ( 4 ) Amlodipine besylate is contraindicated in patients with known sensitivity to amlodipine.
⚠️ Warnings and Cautions ▾
5 WARNINGS AND PRECAUTIONS • Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. However, acute hypotension is unlikely. ( 5.1 ) • Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of Amlodipine besylate tablet, USP, particularly in patients with severe obstructive coronary artery disease. ( 5.2 ) • Titrate slowly in patients with severe hepatic impairment. ( 5.3 )
5.1Hypotension Symptomatic hypotension is possible, particularly in patients with severe aortic stenosis. Because of the gradual onset of action, acute hypotension is unlikely.
5.2Increased Angina or Myocardial Infarction Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of amlodipine besylate, particularly in patients with severe obstructive coronary artery disease.
5.3Patients with Hepatic Failure Because amlodipine besylate is extensively metabolized by the liver and the plasma elimination half-life (t 1/2 ) is 56 hours in patients with impaired hepatic function, titrate slowly when administering amlodipine besylate to patients with severe hepatic impairment.
🤒 Adverse Reactions ▾
6 ADVERSE REACTIONS Most common adverse reaction to amlodipine is edema which occurred in a dose related manner. Other adverse experiences not dose related but reported with an incidence >1.0% are fatigue, nausea, abdominal pain, and somnolence. ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Cipla Limited, India at 1- 866-604-3268 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch .
6.1Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Amlodipine besylate has been evaluated for safety in more than 11,000 patients in U.S. and foreign clinical trials. In general, treatment with amlodipine besylate was well-tolerated at doses up to 10 mg daily.
Most adverse reactions reported during therapy with amlodipine besylate were of mild or moderate severity. In controlled clinical trials directly comparing amlodipine (N=1730) at doses up to 10 mg to placebo (N=1250), discontinuation of amlodipine besylate because of adverse reactions was required in only about 1.5% of patients and was not significantly different from placebo (about 1%). The most commonly reported side effects more frequent than placebo are reflected in the table below.
The incidence (%) of side effects that occurred in a dose related manner are as follows: Amlodipine besylate Placebo 2.5mg N=275 5mg N=296 10mg N=268 N=520 Edema 1.8 3.0 10.8
0.6Dizziness 1.1 3.4 3.4
1.5Flushing 0.7 1.4 2.6
0.0Palpitation 0.7 1.4 4.5
0.6Other adverse reactions that were not clearly dose related but were reported with an incidence greater than 1.0% in placebo-controlled clinical trials include the following: Amlodipine besylate (%) Placebo (%) N=1730 N=1250 Fatigue 4.5
2.8Nausea 2.9
1.9Abdominal pain 1.6
0.3Somnolence 1.4
0.6For several adverse experiences that appear to be drug and dose related, there was a greater incidence in women than men associated with amlodipine treatment as shown in the following table: Amlodipine besylate Placebo Male=% (N=1218) Female=% (N=512) Male=% (N=914) Female=% (N=336) Edema 5.6 14.6 1.4
5.1Flushing 1.5 4.5 0.3
0.9Palpitations 1.4 3.3 0.9
0.9Somnolence 1.3 1.6 0.8
0.3The following events occurred in <1% but >0.1% of patients in controlled clinical trials or under conditions of open trials or marketing experience where a causal relationship is uncertain; they are listed to alert the physician to a possible relationship: Cardiovascular: arrhythmia (including ventricular tachycardia and atrial fibrillation), bradycardia, chest pain, peripheral ischemia, syncope, tachycardia, vasculitis. Central and Peripheral Nervous System: hypoesthesia, neuropathy peripheral, paresthesia, tremor, vertigo.
Gastrointestinal: anorexia, constipation, dysphagia, diarrhea, flatulence, pancreatitis, vomiting, gingival hyperplasia. General: allergic reaction, asthenia, 1 back pain, hot flushes, malaise, pain, rigors, weight gain, weight decrease. Musculoskeletal System: arthralgia, arthrosis, muscle cramps, 1 myalgia.
Psychiatric: sexual dysfunction (male 1 and female), insomnia, nervousness, depression, abnormal dreams, anxiety, depersonalization. Respiratory System: dyspnea, 1 epistaxis. Skin and Appendages: angioedema, erythema multiforme, pruritus, 1 rash, 1 rash erythematous, rash maculopapular.
Special Senses: abnormal vision, conjunctivitis, diplopia, eye pain, tinnitus. Urinary System: micturition frequency, micturition disorder, nocturia. Autonomic Nervous System: dry mouth, sweating increased.
Metabolic and Nutritional: hyperglycemia, thirst. Hemopoietic: leukopenia, purpura, thrombocytopenia. 1 These events occurred in less than 1% in placebo-controlled trials, but the incidence of these side effects was between 1% and 2% in all multiple dose studies.
Amlodipine besylate therapy has not been associated with clinically s…
🔄 Drug Interactions ▾
7 DRUG INTERACTIONS • Do not exceed doses greater than 20 mg daily of simvastatin. ( 7.2 )
7.1Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. Monitor for symptoms of hypotension and edema when amlodipine is co-administered with CYP3A inhibitors to determine the need for dose adjustment [see Clinical Pharmacology ( 12.3 )] . CYP3A Inducers No information is available on the quantitative effects of CYP3A inducers on amlodipine.
Blood pressure should be closely monitored when amlodipine is co‑administered with CYP3A inducers. Sildenafil Monitor for hypotension when sildenafil is co‑administered with amlodipine [see Clinical Pharmacology ( 12.2 )] .
7.2Impact of Amlodipine on Other Drugs Simvastatin Co-administration of simvastatin with amlodipine increases the systemic exposure of simvastatin. Limit the dose of simvastatin in patients on amlodipine to 20 mg daily [see Clinical Pharmacology ( 12.3 )]. Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co‑administered.
Frequent monitoring of trough blood levels of cyclosporine and tacrolimus is recommended and adjust the dose when appropriate [see Clinical Pharmacology ( 12.3 )].
👥 Use in Specific Populations ▾
8 USE IN SPECIFIC POPULATIONS • Pediatric: Effect on patients less than 6 years old is not known. ( 8.4 ) • Geriatric: Start dosing at the low end of the dose range. ( 8.5 )
8.1Pregnancy Risk Summary The limited available data based on post-marketing reports with NORVASC use in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage. There are risks to the mother and fetus associated with poorly controlled hypertension in pregnancy [see Clinical Considerations] . In animal reproduction studies, there was no evidence of adverse developmental effects when pregnant rats and rabbits were treated orally with amlodipine maleate during organogenesis at doses approximately 10 and 20-times the maximum recommended human dose (MRHD), respectively.
However for rats, litter size was significantly decreased (by about 50%) and the number of intrauterine deaths was significantly increased (about 5-fold). Amlodipine has been shown to prolong both the gestation period and the duration of labor in rats at this dose [see Data]. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown.
All pregnancies have a background risk of birth defect, loss or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2%-4% and 15%-20%, respectively. Clinical Considerations Disease-associated maternal and/or embryo/fetal risk Hypertension in pregnancy increases the maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section and post-partum hemorrhage).
Hypertension increases the fetal risk for intrauterine growth restriction and intrauterine death. Pregnant women with hypertension should be carefully monitored and managed accordingly. Data Animal Data No evidence of teratogenicity or other embryo/fetal toxicity was found when pregnant rats and rabbits were treated orally with amlodipine maleate at doses up to 10 mg amlodipine/kg/day (approximately 10 and 20 times the MRHD based on body surface area, respectively) during their respective periods of major organogenesis.
However for rats, litter size was significantly decreased (by about 50%) and the number of intrauterine deaths was significantly increased (about 5-fold) in rats receiving amlodipine maleate at a dose equivalent to 10 mg amlodipine/kg/day for 14 days before mating and throughout mating and gestation. Amlodipine maleate has been shown to prolong both the gestation period and the duration of labor in rats at this dose.
8.2Lactation Risk Summary Limited available data from a published clinical lactation study reports that amlodipine is present in human milk at an estimated median relative infant dose of 4.2%. No adverse effects of amlodipine on the breastfed infant have been observed. There is no available information on the effects of amlodipine on milk production.
8.4Pediatric Use Amlodipine besylate (2.5 to 5 mg daily) is effective in lowering blood pressure in patients 6 to 17 years [see Clinical Studies (14.1) ] . Effect of amlodipine besylate on blood pressure in patients less than 6 years of age is not known.
8.5Geriatric Use Clinical studies of amlodipine besylate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
Elderly patients have decreased clearance of amlodipine with a resulting increase of AUC of approximately 40–60%, and a lower initial dose may be…
🤰 Pregnancy ▾
8.1Pregnancy Risk Summary The limited available data based on post-marketing reports with NORVASC use in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage. There are risks to the mother and fetus associated with poorly controlled hypertension in pregnancy [see Clinical Considerations] . In animal reproduction studies, there was no evidence of adverse developmental effects when pregnant rats and rabbits were treated orally with amlodipine maleate during organogenesis at doses approximately 10 and 20-times the maximum recommended human dose (MRHD), respectively.
However for rats, litter size was significantly decreased (by about 50%) and the number of intrauterine deaths was significantly increased (about 5-fold). Amlodipine has been shown to prolong both the gestation period and the duration of labor in rats at this dose [see Data]. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown.
All pregnancies have a background risk of birth defect, loss or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2%-4% and 15%-20%, respectively. Clinical Considerations Disease-associated maternal and/or embryo/fetal risk Hypertension in pregnancy increases the maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section and post-partum hemorrhage).
Hypertension increases the fetal risk for intrauterine growth restriction and intrauterine death. Pregnant women with hypertension should be carefully monitored and managed accordingly. Data Animal Data No evidence of teratogenicity or other embryo/fetal toxicity was found when pregnant rats and rabbits were treated orally with amlodipine maleate at doses up to 10 mg amlodipine/kg/day (approximately 10 and 20 times the MRHD based on body surface area, respectively) during their respective periods of major organogenesis.
However for rats, litter size was significantly decreased (by about 50%) and the number of intrauterine deaths was significantly increased (about 5-fold) in rats receiving amlodipine maleate at a dose equivalent to 10 mg amlodipine/kg/day for 14 days before mating and throughout mating and gestation. Amlodipine maleate has been shown to prolong both the gestation period and the duration of labor in rats at this dose.
🧒 Pediatric Use ▾
8.4Pediatric Use Amlodipine besylate (2.5 to 5 mg daily) is effective in lowering blood pressure in patients 6 to 17 years [see Clinical Studies (14.1) ] . Effect of amlodipine besylate on blood pressure in patients less than 6 years of age is not known.
🧓 Geriatric Use ▾
8.5Geriatric Use Clinical studies of amlodipine besylate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
Elderly patients have decreased clearance of amlodipine with a resulting increase of AUC of approximately 40–60%, and a lower initial dose may be required [see Dosage and Administration (2.1) ] .
🆘 Overdosage ▾
10 OVERDOSAGE Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly a reflex tachycardia. In humans, experience with intentional overdosage of amlodipine besylate is limited. Single oral doses of amlodipine maleate equivalent to 40 mg amlodipine/kg and 100 mg amlodipine/kg in mice and rats, respectively, caused deaths.
Single oral amlodipine maleate doses equivalent to 4 or more mg amlodipine/kg or higher in dogs (11 or more times the maximum recommended human dose on a mg/m 2 basis) caused a marked peripheral vasodilation and hypotension. If massive overdose should occur, initiate active cardiac and respiratory monitoring. Frequent blood pressure measurements are essential.
Should hypotension occur, provide cardiovascular support including elevation of the extremities and the judicious administration of fluids. If hypotension remains unresponsive to these conservative measures, consider administration of vasopressors (such as phenylephrine) with attention to circulating volume and urine output. As amlodipine besylate is highly protein bound, hemodialysis is not likely to be of benefit.
🧬 Clinical Pharmacology ▾
12 CLINICAL PHARMACOLOGY
12.1Mechanism of Action Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow-channel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Experimental data suggest that amlodipine binds to both dihydropyridine and nondihydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels.
Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Negative inotropic effects can be detected in vitro but such effects have not been seen in intact animals at therapeutic doses. Serum calcium concentration is not affected by amlodipine.
Within the physiologic pH range, amlodipine is an ionized compound (pKa=8.6), and its kinetic interaction with the calcium channel receptor is characterized by a gradual rate of association and dissociation with the receptor binding site, resulting in a gradual onset of effect. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure. The precise mechanisms by which amlodipine relieves angina have not been fully delineated, but are thought to include the following: Exertional Angina: In patients with exertional angina, amlodipine besylate reduces the total peripheral resistance (after load) against which the heart works and reduces the rate pressure product, and thus myocardial oxygen demand, at any given level of exercise.
Vasospastic Angina: Amlodipine besylate has been demonstrated to block constriction and restore blood flow in coronary arteries and arterioles in response to calcium, potassium epinephrine, serotonin, and thromboxane A2 analog in experimental animal models and in human coronary vessels in vitro . This inhibition of coronary spasm is responsible for the effectiveness of amlodipine besylate in vasospastic (Prinzmetal's or variant) angina.
12.2Pharmacodynamics Hemodynamics: Following administration of therapeutic doses to patients with hypertension, amlodipine besylate produces vasodilation resulting in a reduction of supine and standing blood pressures. These decreases in blood pressure are not accompanied by a significant change in heart rate or plasma catecholamine levels with chronic dosing. Although the acute intravenous administration of amlodipine besylate decreases arterial blood pressure and increases heart rate in hemodynamic studies of patients with chronic stable angina, chronic oral administration of amlodipine in clinical trials did not lead to clinically significant changes in heart rate or blood pressures in normotensive patients with angina.
With chronic once daily oral administration, antihypertensive effectiveness is maintained for at least 24 hours. Plasma concentrations correlate with effect in both young and elderly patients. The magnitude of reduction in blood pressure with amlodipine besylate is also correlated with the height of pretreatment elevation; thus, individuals with moderate hypertension (Diastolic pressure 105–114 mmHg) had about a 50% greater response than patients with mild hypertension (diastolic pressure 90–104 mmHg).
Normotensive subjects experienced no clinically significant change in blood pressures (+1/–2 mmHg). In hypertensive patients with normal renal function, therapeutic doses of amlodipine besylate resulted in a decrease in renal vascular resistance and an increase in glomerular filtration rate and effective renal plasma flow without change in filtration fraction or proteinuria. As with other calcium channel blockers, hemodynamic measurements of cardiac function at rest and during exercise (or pacing) in patients with normal ventricular function treated with amlodipine…
🧬 Mechanism of Action ▾
12.1Mechanism of Action Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow-channel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Experimental data suggest that amlodipine binds to both dihydropyridine and nondihydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels.
Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Negative inotropic effects can be detected in vitro but such effects have not been seen in intact animals at therapeutic doses. Serum calcium concentration is not affected by amlodipine.
Within the physiologic pH range, amlodipine is an ionized compound (pKa=8.6), and its kinetic interaction with the calcium channel receptor is characterized by a gradual rate of association and dissociation with the receptor binding site, resulting in a gradual onset of effect. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure. The precise mechanisms by which amlodipine relieves angina have not been fully delineated, but are thought to include the following: Exertional Angina: In patients with exertional angina, amlodipine besylate reduces the total peripheral resistance (after load) against which the heart works and reduces the rate pressure product, and thus myocardial oxygen demand, at any given level of exercise.
Vasospastic Angina: Amlodipine besylate has been demonstrated to block constriction and restore blood flow in coronary arteries and arterioles in response to calcium, potassium epinephrine, serotonin, and thromboxane A2 analog in experimental animal models and in human coronary vessels in vitro . This inhibition of coronary spasm is responsible for the effectiveness of amlodipine besylate in vasospastic (Prinzmetal's or variant) angina.
📦 How Supplied / Storage and Handling ▾
16 HOW SUPPLIED/STORAGE AND HANDLING 10 mg Tablets Amlodipine Besylate Tablets, USP - 10 mg (Amlodipine besylate USP equivalent to 10 mg of Amlodipine per tablet) are supplied as white to off white round tablets with "128" debossed on one side and "C" on other side and supplied as follows: NDC 71335-0218-1: 30 Tablets in a BOTTLE NDC 71335-0218-2: 90 Tablets in a BOTTLE NDC 71335-0218-3: 60 Tablets in a BOTTLE NDC 71335-0218-4: 120 Tablets in a BOTTLE NDC 71335-0218-5: 100 Tablets in a BOTTLE NDC 71335-0218-6: 800 Tablets in a BOTTLE NDC 71335-0218-7: 1000 Tablets in a BOTTLE NDC 71335-0218-8: 180 Tablets in a BOTTLE NDC 71335-0218-9: 10 Tablets in a BOTTLE NDC 71335-0218-0: 7 Tablets in a BOTTLE Store at 20°C to 25°C (68°F to 77°F). [See USP controlled room temperature.] Protect from light and moisture.
Repackaged/Relabeled by: Bryant Ranch Prepack Burbank, CA 91504
📋 Description ▾
11 DESCRIPTION Amlodipine besylate is the besylate salt of amlodipine, a long-acting calcium channel blocker. Amlodipine besylate is chemically described as 3-Ethyl-5-methyl (±)-2-[(2-aminoethoxy) methyl]-4-(2-chlorophenyl)-1, 4-dihydro-6-methyl-3, 5-pyridinedicarboxylate, monobenzenesulphonate. Its molecular formula is C 20 H 25 CIN 2 O 5 •C 6 H 6 O 3 S, and its structural formula is: Amlodipine besylate is a white or almost white powder with a molecular weight of 567.1.
It is slightly soluble in water and sparingly soluble in ethanol. Amlodipine besylate tablets, USP are formulated as white to off white tablets equivalent to 2.5, 5, and 10 mg of amlodipine for oral administration. In addition to the active ingredient, amlodipine besylate, each tablet contains the following inactive ingredients: microcrystalline cellulose, dibasic calcium phosphate dihydrate, sodium starch glycolate, colloidal silicon dioxide and magnesium stearate.