Amlodipine
Amlodipine is a calcium channel blocker. Norvasc’s label states it is indicated for the treatment of hypertension and for the symptomatic treatment of chronic stable angina. Norvasc contains amlodipine alone, while Azor, Tribenzor and Exforge combine it with other active ingredients.
Key points
- Norvasc’s label states amlodipine is indicated for the treatment of hypertension and for the symptomatic treatment of chronic stable angina.
- Amlodipine’s absolute bioavailability is estimated at 64 to 90%, with a terminal elimination half-life of about 30 to 50 hours.
- Oedema, amlodipine’s most commonly reported adverse reaction, occurred in a dose-related manner in placebo-controlled trials: 10.8% of patients on the 10 mg dose, and 0.6% of those on placebo.
- Amlodipine is extensively metabolised, about 90%, to inactive metabolites in the liver, with the remainder excreted largely unchanged in the urine.
What amlodipine treats, and how it behaves in the body
The Norvasc label states amlodipine is indicated for the treatment of hypertension, to lower blood pressure, and for the symptomatic treatment of chronic stable angina. Azor combines amlodipine with olmesartan medoxomil, Exforge combines it with valsartan, and Tribenzor combines it with olmesartan medoxomil and hydrochlorothiazide.
Amlodipine’s absolute bioavailability is estimated at 64 to 90%, and it is extensively metabolised, about 90%, to inactive metabolites in the liver, with the remainder excreted largely unchanged in the urine. Its terminal elimination half-life is about 30 to 50 hours; the label notes this half-life lengthens to about 56 hours in patients with impaired hepatic function, who should have their dose increased gradually.
Safety: hypotension, angina risk and oedema
The label’s warnings and precautions open with hypotension: symptomatic hypotension is possible, particularly in patients with severe aortic stenosis, though acute hypotension is unlikely given amlodipine’s gradual onset of action. The label separately warns that worsening angina and acute myocardial infarction can develop after starting or increasing the amlodipine dose, particularly in patients with severe obstructive coronary artery disease. Oedema, the most commonly reported adverse reaction, occurred in a dose-related manner in placebo-controlled trials: 10.8% of patients on the 10 mg dose, and 0.6% of those on placebo.
Norvasc: a regional record
The Emirates Drug Establishment’s drug directory records Norvasc 5 mg with amlodipine besylate as its ingredient. That record describes its form as a capsule, and Norvasc itself is a familiar regional name for readers who know amlodipine this way.
Further reading
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