A first-line blood pressure medicine. The ankle swelling is dose-related and often solved by combining rather than increasing.
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Amlodipine is a calcium channel blocker. It stops calcium entering the muscle cells in artery walls, which relaxes those arteries and lowers the pressure inside them.
It is long-acting, taken once daily, and is first-line treatment for people over 55, and for people of Black African or Caribbean heritage at any age — because these groups tend to respond better to it than to ACE inhibitors.
Once daily, at the same time each day. Morning or evening both work — pick whichever you will remember.
With or without food.
Swallow whole.
Avoid large quantities of grapefruit juice, which raises amlodipine levels.
If you miss a dose, take it when you remember unless the next is nearly due. Do not double up.
It takes a week or two to reach full effect — do not judge it on the first few days.
Ankle and lower leg swelling is the characteristic one, and it is common. It happens because amlodipine dilates the small arteries more than the veins, so fluid leaks into the tissues. It is not fluid retention in the way heart failure is, and diuretics do not fix it well.
What does help is worth knowing: the swelling is dose-related, and combining a lower dose of amlodipine with an ACE inhibitor or ARB often controls blood pressure just as well with far less swelling. Increasing the amlodipine dose alone tends to make it worse. This is a routine adjustment that many people never get offered.
Other common effects: flushing, headache (usually settling after the first couple of weeks), dizziness, and fatigue.
Less commonly: palpitations, nausea, and gum swelling.
Care is needed with significant liver impairment, where the dose is usually reduced.
In pregnancy, amlodipine is not first choice — labetalol and nifedipine are generally preferred, and this should be reviewed before conception.
Simvastatin — amlodipine raises its levels, and the simvastatin dose is usually capped at 20mg when the two are combined. This is a common combination and a frequently missed interaction.
Other interactions: grapefruit juice, clarithromycin, some antifungals, ciclosporin, and other blood pressure medicines used together.
Monitoring: blood pressure, ideally from home readings. Kidney function and electrolytes are usually checked as part of overall cardiovascular assessment rather than because amlodipine itself requires it — unlike ACE inhibitors, it does not need routine bloods after starting.
Yes, where clinically appropriate. Blood pressure management suits remote care particularly well, because the readings that matter are the ones you take at home rather than the one taken while you sit in a waiting room feeling mildly anxious about it.
What that involves: home readings twice daily for seven days on a validated upper-arm monitor, a full history including the things that raise blood pressure and are routinely overlooked — NSAIDs, decongestants, the combined pill, alcohol, sleep apnoea — baseline bloods, and a formal cardiovascular risk calculation.
If you are already on amlodipine and have swollen ankles, that is worth a consultation in itself. It is a solvable problem and the solution is usually a combination rather than a higher dose.
A reading of 180/120 or above with headache, chest pain, breathlessness or visual disturbance needs emergency assessment, not an online appointment.
This page is information, not an offer to supply.
Amlodipine is one of the cheapest medicines in routine use. It has been off patent for years, and the generic is what almost everyone gets.
On a private prescription you pay the pharmacy the actual cost of the drug plus their dispensing fee, and for amlodipine that will usually come to less than the standard NHS prescription charge in England of around £10.
Prescriptions are free in Wales, so if you are registered with a Welsh GP the NHS route is cheaper by definition.
There is no branded version worth paying for. Amlodipine is amlodipine.
Nor is there any benefit in a modified-release or combination product unless you are also taking the other drug in it — combination tablets are convenient rather than better, and they cost more.
Ask for a three-month supply once you are stable. It reduces both the dispensing fees and the number of trips.
Amlodipine causes no withdrawal effects and does not need tapering. It can be stopped abruptly if it needs to be.
What happens instead is simple: your blood pressure goes back up over a week or two. That is not a rebound — it is the underlying blood pressure reappearing because nothing is now treating it.
Ankle swelling. It affects a meaningful minority, is dose-related, and is not a sign of heart failure — it is fluid pushed into the tissues by the way the drug widens small arteries.
It is worth knowing that adding an ACE inhibitor such as ramipril often reduces the swelling, which is a better answer than abandoning a drug that is working. Compression socks and leg elevation help; diuretics generally do not.
Amlodipine is usually swapped straight for the alternative with no washout period. Keep taking home readings through the change, because the first fortnight is when you find out whether the new drug suits you.
Do not stop it because you feel well. High blood pressure has no symptoms, and feeling fine is not evidence that you no longer need treatment.
It is the commonest side effect and it is not dangerous. Amlodipine widens small arteries, which pushes fluid into the tissue around the ankles.
It is dose-related, so halving the dose often helps, and adding an ACE inhibitor frequently settles it. Water tablets do not work for this.
Usually, but not inevitably. Substantial weight loss, cutting alcohol and reducing salt can lower blood pressure enough that the dose comes down or the drug stops.
That has to be led by home readings rather than by how you feel.
Take it at the same time each day — the specific time matters less than the consistency.
Evening dosing is sometimes suggested and the evidence for it is genuinely mixed. If the timing helps you remember, that is the better reason to choose it.
Best avoided in quantity. Grapefruit raises amlodipine levels and can increase the swelling and flushing.
An occasional glass is unlikely to matter; a daily litre is a different question.
Take it when you remember, unless it is nearly time for the next one. Never double up.
Amlodipine lasts a long time in the body, so a single missed dose has little effect.
Less often than beta blockers do. Flushing, headache in the first fortnight and ankle swelling are the usual complaints.
Early headache usually settles, and it is worth giving it two weeks before deciding.
Yes, and you should. Amlodipine does not blunt your heart rate response the way a beta blocker does.
It is not first choice. If you are pregnant or planning to be, this needs reviewing before conception rather than after — labetalol and nifedipine are the usual alternatives.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 24, 2026
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