Meta Information
ID:amlodipine
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/cyp3a4-strong-inhibitors
Target name:
Strong CYP3A4 Inhibitors (e.g., Ketoconazole, Clarithromycin, Ritonavir)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Strong CYP3A4 inhibitors block the primary enzyme that breaks down amlodipine, leading to dangerously high drug levels, which can cause severe low blood pressure, dizziness, and swelling.
Actionable advice:
Avoid using these medications together; if unavoidable, a significant dose reduction of amlodipine is required under close medical supervision.
Target id:
/intervention/simvastatin
Target name:
Simvastatin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Amlodipine inhibits the breakdown of simvastatin, increasing its concentration in the blood and raising the risk of muscle-related side effects, including a rare but serious condition called rhabdomyolysis.
Actionable advice:
Do not exceed a daily dose of 20 mg of simvastatin when taking amlodipine.
Target id:
/intervention/pde5-inhibitors
Target name:
PDE5 Inhibitors (e.g., Sildenafil, Tadalafil)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Both amlodipine and PDE5 inhibitors are vasodilators; their combined use can cause an additive effect, leading to a significant and potentially dangerous drop in blood pressure.
Actionable advice:
Use with caution under medical guidance, and be aware of the increased risk for dizziness and fainting.
Target id:
/class/immunosuppressants
Target name:
Calcineurin Inhibitors (e.g., Cyclosporine, Tacrolimus)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Amlodipine can increase the blood levels of these immunosuppressants, heightening the risk of toxicity, particularly kidney damage.
Actionable advice:
This combination requires close monitoring of immunosuppressant drug levels and kidney function by a physician.
Target id:
/condition/hepatic-impairment
Target name:
Severe Liver Disease
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The liver is responsible for breaking down amlodipine; severe liver impairment dramatically slows this process, leading to high drug levels and an increased risk of side effects.
Actionable advice:
A lower starting dose and careful dose increases are necessary under medical supervision for patients with severe liver disease.
Target id:
/class/cyp3a4-moderate-inhibitors
Target name:
Moderate CYP3A4 Inhibitors (e.g., Diltiazem, Verapamil, Fluconazole)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
These drugs moderately block the enzyme that metabolizes amlodipine, increasing its concentration and the risk of side effects like low blood pressure, dizziness, and fluid retention.
Actionable advice:
Use with caution and monitor for increased side effects; your doctor may need to lower your amlodipine dose.
Target id:
/dietary/grapefruit-pomelo
Target name:
Grapefruit and Grapefruit Juice
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Compounds in grapefruit inhibit the CYP3A4 enzyme in the gut wall, increasing the absorption and blood levels of amlodipine, which can lead to excessive blood pressure lowering.
Actionable advice:
Avoid consuming grapefruit or its juice while taking amlodipine.
Target id:
/class/broad-spectrum-inducers
Target name:
CYP3A4 Inducers (e.g., Rifampin, Carbamazepine, Phenytoin)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
These medications speed up the enzyme that breaks down amlodipine, significantly lowering its blood levels and reducing its effectiveness at controlling blood pressure.
Actionable advice:
Avoid this combination if possible; your doctor may need to increase your amlodipine dose if co-administration is necessary.
Target id:
/intervention/saint-johns-wort
Target name:
St. John's Wort
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
St. John's Wort induces the CYP3A4 enzyme, which accelerates the metabolism of amlodipine, potentially making it less effective for blood pressure control.
Actionable advice:
Avoid taking St. John's Wort with amlodipine due to the risk of reduced efficacy.
Target id:
/class/antihypertensives
Target name:
Other Blood Pressure Lowering Medications
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Combining amlodipine with other antihypertensives has an additive effect, which is often intentional but can sometimes lead to excessive blood pressure drops (hypotension).
Actionable advice:
Monitor for dizziness or lightheadedness, especially when starting or changing doses of any blood pressure medication.
Target id:
/class/statins
Target name:
Certain Statins (especially Atorvastatin, Lovastatin)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Amlodipine can modestly increase the levels of statins that are metabolized by CYP3A4, potentially increasing the risk of muscle pain or weakness.
Actionable advice:
Monitor for muscle-related side effects; your doctor may consider a lower statin dose or a different statin.
Target id:
/condition/geriatric
Target name:
Older Adults (Geriatric)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Older adults may have slower clearance of amlodipine and be more sensitive to its blood pressure-lowering effects, increasing the risk of falls from dizziness or hypotension.
Actionable advice:
A lower starting dose is recommended for older adults, with gradual increases as needed under medical supervision.
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
null
Description:
Some evidence suggests that taking blood pressure medication in the evening may improve control of nighttime blood pressure, and amlodipine's long half-life makes it suitable for this strategy.
Actionable advice:
Consider taking amlodipine in the evening, but maintaining a consistent time each day is the most important factor.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Amlodipine's absorption is not significantly affected by food, allowing for flexible dosing. Taking it with a meal can aid in establishing a consistent daily routine and minimize potential stomach upset.
Actionable advice:
You can take amlodipine with or without food at the same time each day.
Target id:
/intervention/calcium-citrate
Target name:
High-Dose Calcium Supplements
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Theoretically, large supplemental doses of calcium could counteract the mechanism of a calcium channel blocker, potentially reducing its effectiveness, though this is not well-established clinically.
Actionable advice:
Standard calcium supplementation is generally safe, but avoid very high doses without consulting your doctor.