Norvascamlodipine besylate
Also sold as: Amlodipine (multiple Canadian generics)
A once-daily blood pressure tablet that relaxes blood vessels; ankle swelling is its most familiar side effect.
Quick answer
- What it is
- A dihydropyridine calcium channel blocker — it relaxes the muscle in artery walls so blood flows with less resistance.
- What it's used for
- High blood pressure and certain types of angina (chest pain from reduced blood flow to the heart).
- Worth knowing
- Once daily at roughly the same time. It takes a week or two to reach full effect, so blood pressure is not judged on day one.
- Main safety point
- Swollen ankles, flushing and headache are typical and dose-related. Do not stop suddenly if you also take a beta blocker for angina — check first.
Already taking Norvasc? Pill4Me pharmacists in Chilliwack can help.
Drug class
Calcium channel blocker (dihydropyridine)
Use in Canada
4,300,000 prescriptions
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 Norvasc 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 and strengths
Tablets: 5 mg and 10 mg. Generic amlodipine is widely available and interchangeable with Norvasc.
How Norvasc is taken
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.
This is general information, not a dose for you. Dosing depends on the reason you are taking it, your kidney and liver function, your age, and everything else you take — follow the directions on your own label, and ask us if they differ from what you read here.
If you miss a dose
Take it as soon as you remember on the same day. If it is almost time for the next dose, skip the missed one — doubling up can drop your blood pressure too far and cause dizziness.
Side effects
Common — usually manageable
- 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
Get medical help for these
- 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 take extra care
- Severe aortic stenosis or very low blood pressure
- Vasodilators can be poorly tolerated — needs physician judgement.
- Older adults
- Higher risk of dizziness and falls when standing up; doses are often started low.
- Liver impairment
- Amlodipine is cleared by the liver, so lower doses are used.
- Grapefruit
- Large amounts of grapefruit juice can raise amlodipine levels — occasional small amounts are usually fine, but ask if you drink it daily.
- Ankle swelling
- Common and not dangerous, but if it bothers you there are alternatives — this is worth raising rather than stopping the medication yourself.
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.
Commonly asked about alongside Norvasc: Lipitor, Crestor.
This is not a complete list. If you take several medications, or buy anything over the counter, a pharmacist medication review is the reliable way to catch interactions that matter.
Coverage in British Columbia
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 may depend on indication, PharmaCare plan and Special Authority requirements. Ask Pill4Me Pharmacy to check your coverage, or see BC PharmaCare.
Frequently asked questions
Why do my ankles swell since starting amlodipine?
Can I eat grapefruit while taking amlodipine?
Can I take amlodipine at any time of day?
What happens if I miss a dose?
How long will it take amlodipine to lower my blood pressure?
Related reading
Related medications
Conditions it’s used for
Already taking Norvasc?
Move your prescription to Pill4Me and we handle the rest — we contact your current pharmacy, and refills, reminders and free local delivery come with it.
Pill4Me Pharmacy is at 5625 Promontory Rd Unit 101, Chilliwack, BC. We deliver free to Chilliwack, Sardis, Promontory, Vedder and Yarrow, and you can reach a pharmacist directly at 604-705-3644.