Calcium channel blocker (dihydropyridine)·#9 most prescribed in Canada

Norvascamlodipine besylate

Also known as: Amlodipine (multiple Canadian generics)

Norvasc (amlodipine) treats high blood pressure and chest pain (angina). Learn about dosing, side effects, and BC PharmaCare coverage at Pill4Me Pharmacy Chilliwack.

Prescriptions (Canada 2024)

4,300,000 prescriptions

Drug class

Calcium channel blocker (dihydropyridine)

DIN (Canada)

00878928, 00878936

What is Norvasc?

Norvasc is used to treat high blood pressure (hypertension) and chronic stable angina (chest pain caused by reduced blood flow to the heart). It may also be used for vasospastic angina (Prinzmetal's or variant angina), a type of angina caused by coronary artery spasm.

How it works

Amlodipine blocks calcium from entering the smooth muscle cells of blood vessels and the heart. When calcium is blocked, blood vessels relax and widen, reducing the resistance the heart must pump against. This lowers blood pressure and increases blood flow to the heart muscle, relieving angina. The effect is gradual, building up over 1–2 weeks.

Forms & strengths

Tablets: 5 mg and 10 mg. Generic amlodipine is widely available and interchangeable with Norvasc.

How to take it

Taken once daily at any consistent time of day, with or without food. Starting dose is usually 5 mg. May be increased to 10 mg based on blood pressure response. Effects on blood pressure develop gradually over the first 1–2 weeks — do not increase your dose prematurely. Do not stop suddenly without speaking to your doctor.

Side effects

Common side effects

Ankle and lower leg swelling (peripheral edema) — occurs in up to 10–15% of patients, especially women
Flushing or facial warmth, especially in the first few weeks
Headache
Dizziness, especially when standing up quickly
Fatigue or tiredness
Palpitations (awareness of heartbeat)
Nausea or stomach discomfort

Serious side effects — seek care immediately

Worsening angina or heart attack can rarely occur when first starting or increasing the dose — report any new or worsening chest pain promptly
Severely low blood pressure (hypotension) — more likely if also taking other blood pressure medications, especially when starting
Very rapid or irregular heartbeat — contact your doctor
Severe allergic reaction — hives, facial swelling, difficulty breathing — go to emergency

Important warnings

Ankle swelling is very common and does not mean the medication is harming you — it is caused by blood vessel widening, not heart or kidney problems. Elevating your feet when sitting helps; talk to your pharmacist if it is bothersome

Do not stop amlodipine suddenly — gradually stopping is recommended, especially if used for angina, as abrupt discontinuation can worsen chest pain

Grapefruit and grapefruit juice can significantly increase amlodipine levels by interfering with its metabolism — avoid drinking large amounts of grapefruit juice while on this medication

Tell your dentist and any surgeon before procedures — calcium channel blockers can affect bleeding and interact with anaesthetics

Simvastatin dose must be limited to 20 mg/day when used with amlodipine — ask your pharmacist if you are on both

Who should not take it

Cardiogenic shock (severely impaired heart pumping)
Severe aortic stenosis (narrowed aortic valve) — use with caution, discuss with cardiologist
Allergy to amlodipine or other dihydropyridine calcium channel blockers
Unstable angina (different from stable angina — requires different management)

Drug interactions

Simvastatin: amlodipine increases simvastatin levels — simvastatin dose should not exceed 20 mg/day (switch to atorvastatin or rosuvastatin to avoid this interaction). Cyclosporine levels increase significantly with amlodipine — monitoring required. Strong CYP3A4 inhibitors (ketoconazole, clarithromycin, grapefruit juice) increase amlodipine levels. Other blood pressure medications have additive effect — monitor for low blood pressure.

BC PharmaCare coverage

Norvasc (amlodipine) may be covered under BC PharmaCare depending on your plan. Covered under Fair PharmaCare for eligible BC residents. Generic amlodipine is covered — brand name Norvasc may require you to pay the difference. Coverage amounts vary — Fair PharmaCare covers 70–100% after your annual deductible depending on your income. Call us at 604-705-3644 and we'll check your specific coverage in minutes. BC PharmaCare covers the generic version at 100% of the approved price. If you choose the brand name instead of the generic, you pay the difference in cost out of pocket. Your pharmacist can dispense the generic automatically unless your doctor has specified 'no substitution' on the prescription. Coverage information is a general guide only. Your actual coverage depends on your PharmaCare plan and eligibility. We check coverage for free — call 604-705-3644 or ask at the counter.

Coverage details change — confirm with your Pill4Me pharmacist or visit BC PharmaCare.

Frequently asked questions

Why do my ankles swell since starting amlodipine?

Ankle swelling (peripheral oedema) is the most common side effect of amlodipine, affecting up to 15% of patients. It happens because the medication relaxes blood vessels, causing fluid to shift from the vessels into surrounding tissue at the ankles and feet. It is not a sign of heart or kidney problems. Elevating your feet, reducing sodium intake, and staying active can help. If it is severe or bothersome, your doctor may adjust the dose or add a medication to counteract it.

Can I eat grapefruit while taking amlodipine?

Occasional small amounts of grapefruit are likely fine, but drinking large amounts of grapefruit juice daily can significantly increase amlodipine blood levels, potentially causing more side effects like low blood pressure and ankle swelling. It is safest to avoid making grapefruit juice a daily habit while on this medication.

Can I take amlodipine at any time of day?

Yes. Amlodipine has a very long half-life (approximately 35–50 hours), so it does not matter much whether you take it in the morning or evening. The most important thing is consistency — taking it at the same time every day keeps your blood levels stable.

What happens if I miss a dose?

Because amlodipine stays in your system for a very long time, missing one dose is unlikely to cause a significant problem. Take it as soon as you remember on the same day. If you only remember the next day, skip the missed dose and continue your regular schedule. Do not take two doses in one day.

How long will it take amlodipine to lower my blood pressure?

Amlodipine works gradually. You may notice some effect within 24–48 hours of the first dose, but the full blood pressure-lowering effect develops over 1–2 weeks. Do not be discouraged if your readings are not dramatically lower in the first few days. Your doctor will reassess after 4–6 weeks to determine if a dose adjustment is needed.

Related medications

Crestor (rosuvastatin calcium)Lipitor (atorvastatin calcium)Eliquis (apixaban)

Questions about Norvasc?

Our Chilliwack pharmacists can review your medications, check for interactions, and answer any questions — at no charge.

Call 604-705-3644 Transfer my prescription →

Medical disclaimer: This page is for general educational purposes only and does not constitute medical advice. Always consult your pharmacist or prescriber before making any changes to your medications. BC PharmaCare coverage criteria are subject to change.