Amlodipine and Atorvastatin (Oral)

Primarily used to treat high blood pressure and high cholesterol, Amlodipine and Atorvastatin is a combination medication.

Overview

In many cases, people are diagnosed with more than just one medical condition. Some conditions are interlinked, for example, whilst others may simply happen to occur at the same time, in the same patient. Alternatively, one medical condition may require more than one treatment method.

In these situations, patients may be able to take a combination medication. Amlodipine and Atorvastatin is just that. Containing two active ingredients, the medication reduces the number of tablets patients are required to take, whilst still providing effective treatment for their condition(s).

Amlodipine is a calcium channel blocker and works by lowering the patient's blood pressure. By relaxing the walls of the blood vessels, the pressure within them is reduced. In turn, the heart doesn't have to work as hard in order to pump blood around the body.

Although high blood pressure isn't an uncommon condition, it can be dangerous. Unless it's treated adequately, patients have an increased risk of suffering from heart attacks and strokes if they have high blood pressure. In addition to this, high blood pressure has been associated with heart failure, peripheral arterial disease, aortic aneurysms, kidney disease and even vascular dementia.

By prescribing Amlodipine, therefore, physicians can help patients to reduce their blood pressure and their risk of experiencing serious health complications in the future.

Atorvastatin is a type of HMG CoA reductase inhibitor and is more commonly known as a statin. In order to make cholesterol, the body relies on a certain type of enzyme. Atorvastatin blocks this enzyme and, therefore, blocks the body's production of cholesterol. In addition to this, Atorvastatin prevents the increase of low-density lipoprotein (LDL), or bad cholesterol, whilst allowing the high-density lipoprotein (HDL), or good cholesterol, to increase.

Although the body needs cholesterol in order to function, excessive levels of LDL can put patients at risk of certain health conditions. As well as increasing the risk of strokes, heart attacks, and peripheral arterial disease, high cholesterol can also lead to atherosclerosis and transient ischemic attacks, or mini-strokes.

It's essential, therefore, that patients with high levels of cholesterol are able to reduce them. Often, a combination of Atorvastatin and exercise, along with an improved diet, can successfully reduce cholesterol levels and the risks associated with the condition.

It is evident that both high blood pressure and high cholesterol can lead to an increased risk of developing the same health problems in the future. As these two conditions often go hand-in-hand, many patients experience both issues at the same time.

Whilst Amlodipine and Atorvastatin can be prescribed separately, if patients need to take both medications, it makes sense for them to be given as a combined medication, in just one tablet.

Conditions Treated

  • High blood pressure, angina and high cholesterol

Type of Medicine

  • Amlodipine:
    • Calcium Channel Blocker
  • Atorvastatin:
    • HMG CoA reductase inhibitor

Side Effects

When taking a combination medication, it's essential that the side-effects of all active ingredients are taken into account. Similarly, the warnings associated with each active ingredient should be heeded prior to administering or prescribing the medication in question.

Although a range of side-effects could occur when taking either Amlodipine and/or Atorvastatin, the most common side-effects associated with these medications are:

  • Swelling of the ankles and/or feet
  • Tiredness
  • Muscle pain
  • Nausea
  • Extreme fatigue
  • Dizziness
  • Warm feeling in face (flushing)
  • Abnormal muscle movements

If patients experience any of the following, they should consult their doctor as soon as possible. Whilst the following side-effects may not be troublesome, a physician should be aware of their presence and determine whether to continue with treatment:

  • Cough
  • Difficult swallowing
  • Fast heartbeat
  • Fever
  • Hives
  • Itching
  • Skin rash
  • Tightness in the chest
  • Wheezing

There are also some rare side-effects associated with Amlodipine and Atorvastatin. These may include:

  • Black, tarry stools
  • Bleeding gums
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • Chest pain or discomfort
  • Chills
  • Cold and clammy skin
  • Cold sweats
  • Confusion
  • Dark yellow urine
  • Cough
  • Diarrhea
  • Dilated neck veins
  • Dizziness or lightheadedness when getting up from a lying or sitting position
  • Extra heartbeats
  • Irregular heartbeat
  • Shortness of breath
  • Fainting
  • Fever
  • Itching of the skin
  • Joint or muscle pain
  • Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • Numbness and tingling of the face, fingers, or toes
  • Pain in the arms, legs, or lower back, especially pain in the calves or heels upon exertion
  • Painful or difficult urination
  • Pale, bluish-colored, or cold hands or feet
  • Pinpoint red or purple spots on the skin
  • Red, irritated eyes
  • Redness of the face, neck, arms, and occasionally, upper chest
  • Redness, soreness or itching skin
  • Shakiness in the legs, arms, hands, or feet
  • Sore throat
  • Sores, ulcers, or white spots on the lips or in the mouth
  • Sores, welting, or blisters
  • Sudden sweating
  • Sweating
  • Swelling of the face, fingers, feet, or lower legs
  • Swollen glands
  • Trembling or shaking of the hands or feet
  • Unsteadiness or awkwardness
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Weak or absent pulses in the legs
  • Weakness in the arms, hands, legs, or feet
  • Weight gain
  • Yellow eyes or skin

The following side-effects may affect some patients as well. Although rare, patients may want to consult their physician if they experience any of the following:

  • Abnormal dreams
  • Anxiety
  • Back pain
  • Bad unusual or unpleasant (after) taste
  • Bleeding gums
  • Blistering, crusting, irritation, itching, or reddening of the skin
  • Bloating
  • Bloody nose
  • Burning feeling in the chest or stomach
  • Burning while urinating
  • Burning, dry, or itching eyes
  • Change in color of the treated skin
  • Change in sense of smell
  • Change in taste
  • Changes in vision
  • Constipation
  • Continuing ringing or buzzing or other unexplained noise in the ears
  • Cracked, dry, or scaly skin
  • Decreased sexual performance or desire
  • Depression
  • Difficulty with moving
  • Difficulty with swallowing
  • Discharge, excessive tearing
  • Double vision
  • Dry mouth
  • Dryness of the skin
  • Excess air or gas in the stomach or intestines
  • Excessive muscle tone
  • Eye pain
  • Feeling of constant movement of self or surroundings
  • Feeling of unreality
  • Feeling unusually cold
  • Flushed, dry skin
  • Fruit-like breath odor
  • Full feeling
  • General feeling of discomfort or illness
  • Hair loss or thinning of the hair
  • Headache, severe and throbbing
  • Hearing loss
  • Hyperventilation
  • Increased appetite
  • Increased hunger
  • Increased sweating
  • Increased thirst
  • Increased urge to urinate during the night
  • Increased urination
  • Irritability
  • Irritation in the mouth
  • Lack of feeling or emotion
  • Loose stools
  • Loss of memory
  • Muscle tension or tightness
  • Muscle weakness
  • Nervousness
  • Pain
  • Pains in the stomach, side, or abdomen, possibly radiating to the back
  • Passing gas
  • Problems with memory
  • Redness and swelling of the gums
  • Redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • Restlessness
  • Runny nose
  • Seeing double
  • Sensation of spinning
  • Sense of detachment from self or body
  • Shakiness and unsteady walk
  • Shivering
  • Sleeplessness
  • Sneezing
  • Stuffy nose
  • Sweating
  • Swollen joints
  • Tenderness in the stomach area
  • Thirst
  • Trouble in holding or releasing urine
  • Trouble sleeping
  • Twitching
  • Unable to sleep
  • High blood sugar
  • Uncaring
  • Unexplained weight loss
  • Unsteadiness, trembling, or other problems with muscle control or coordination
  • Waking to urinate at night
  • Weight loss
  • Swelling of breast tissue in both male and female patients
  • Soreness of breast tissue in both male and female patients

When taken independently of each other, both Amlodipine and Atorvastatin carry the risk of some side-effects occurring. When taken as a combination medicine, however, the range of possible side-effects increases.

Despite this, the vast majority of patients will experience no side-effects or mild side-effects when taking Amlodipine and Atorvastatin. In many instances, mild side-effects will resolve themselves as patients become accustomed to the treatment.

If patients develop uncomfortable side-effects, or if side-effects persist, they should contact their physician for further advice. If side-effects cause difficulty in breathing, tremors and/or collapse, it's important to seek urgent medical assistance.

Dosage

Amlodipine and Atorvastatin as a combination medication is available in various formats. The lowest dose is typically 5mg/10mg, which indicates that 5mg of Amlodipine Besylate and 10mg of Atorvastatin Calcium is present in the tablet.

Doses of 5mg/20mg, 5mg/40mg, 5mg/80mg are also available. In these preparations, patients are given 5mg of Amlodipine Besylate but the active dose of Atorvastatin Calcium is increased, as indicated by the second figure.

Physicians can also prescribe the medication at doses of 10mg/10mg, which provides equal doses of the two active ingredients; Amlodipine Besylate and Atorvastatin Besylate. Alternatively, doses of 10mg/20mg, 10mg/40mg or 10mg/80mg can be prescribed. Once again, the dose of Amlodipine Besylate remains constant at 10mg but the dose of Atorvastatin Calcium is increased in accordance with patient's symptoms.

Various factors, such as the patient's clinical presentation, medical history, weight, and age, can affect the dosage given. Whilst the above doses are the ones most commonly prescribed, physicians may deviate from these if they feel that it is in the patient's best interests.

Normally, patients will receive Amlodipine and Atorvastatin in tablet format and medication is to be taken once daily. In most instances, patients can take the medication with or without food.

If a dose is missed but the next dose is not due for some time, patients may be able to take their missed dose, albeit a little later than they normally would. If a dose is missed and the next dose is due soon, however, the missed dose should be skipped and the patient should simply carry on with the next dose.

Double doses of the medication should not be taken, even if a dose has been missed.

If a patient misses a dose and is unsure how to proceed, they should seek advice from their doctor or pharmacist.

Normally prescribed in tablet form, patients should swallow the tablet whole. The medication should not be broken or crushed, unless your physician advises it. If the patient is unable to swallow the tablet, they should inform their doctor so that an alternative can be provided.

In all cases, physicians will prescribe a dose and treatment regime which is unique to the patient. Due to this, patients should follow the treatment advice given to them by their own physician.

Potential Drug Interactions

When patients are taking more than one drug or medication, there is the possibility that they will interact with each other. In some instances, this interaction will affect the efficacy of the treatment and may have negative outcomes.

Patients should inform their doctors of any medications, drugs, herbal supplements and/or vitamins they are taking so that their treatment can be modified, if necessary.

Medications or substances which are suspected to interact with Amlodipine and Atorvastatin include:

  • Abiraterone acetate
  • Aliskiren
  • Amiodarone
  • Alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
  • Alpha agonists (e.g., Clonidine, Methyldopa)
  • Amiodarone
  • Amphetamines (e.g., Dextroamphetamine, Lisdexamphetamine)
  • Angiotensin-converting enzyme inhibitors (e.g., Captopril, Ramipril)
  • Angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
  • Antacids (e.g., Aluminum Hydroxide, Calcium Carbonate, Magnesium Hydroxide)
  • Aprepitant
  • Aripiprazole
  • "Azole" antifungal medications (e.g., Fluconazole, Ketoconazole, Itraconazole)
  • Barbiturates (e.g., Phenobarbital)
  • Beta-blockers (e.g., Atenolol, Metoprolol, Propranolol)
  • Bezafibrate
  • Certain biologics (e.g., Brentuximab, Rituximab, Tocilizumab)
  • Birth control pills containing Ethinyl Estradiol and Norethindrone
  • Bosentan
  • Brimonidine
  • Calcium channel blockers (e.g., diltiazem, verapamil)
  • Calcium supplements
  • Certain cancer medications (e.g., Doxorubicin, Etoposide, Methotrexate, Vincristine)
  • Carbamazepine
  • Cetirizine
  • Cholestyramine
  • Cimetidine
  • Ciprofloxacin
  • Clopidogrel
  • Cobicistat
  • Colchicine
  • Colestipol
  • Conivaptan
  • Corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)
  • Cyclosporine
  • Cyproterone
  • Dabigatran
  • Daptomycin
  • Danazol
  • Dapsone
  • Deferasirox
  • Desipramine
  • Dexamethasone
  • Diazoxide
  • Digoxin
  • Dipyridamole
  • Diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide)
  • Dofetilide
  • Dronedarone
  • Duloxetine
  • Eltrombopag
  • Everolimus
  • Estrogens (e.g., Conjugated Estrogen, Estradiol, Ethinylestradiol)
  • Fibrates (e.g., Bezafibrate, Gemfibrozil, Fenofibrate)
  • Fusidic acid
  • "Gliptin" diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
  • Grapefruit juice
  • Guanfacine
  • Haloperidol
  • Hepatitis protease inhibitors (e.g., Boceprevir, Simeprevir, Telaprevir)
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., Delavirdine, Efavirenz, Etravirine, Nevirapine)
  • HIV protease inhibitors (e.g., Atazanavir, Indinavir, Ritonavir, Saquinavir)
  • Ivermectin
  • Levodopa
  • Lomitapide
  • Loperamide
  • Macrolide antibiotics (e.g., Clarithromycin, Erythromycin)
  • Magnesium salts (e.g., Magnesium Oxide, Magnesium Hydroxide)
  • Mefloquine
  • Melatonin
  • Methylphenidate
  • Metronidazole
  • Midazolam
  • Mifepristone
  • Minoxidil
  • Modafinil
  • Monoamine oxidase inhibitors (MAOIs; e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline,
  • Tranylcypromine)
  • Nadolol
  • Nefazodone
  • Niacin
  • Niacinamide
  • Nitrates (e.g., Nitroglycerin, Isosorbide Dinitrate, Isosorbide Mononitrate)
  • Norfloxacin
  • Ondansetron
  • Pentoxyifylline
  • Phenytoin
  • Pimozide
  • Primidone
  • Quinidine
  • Phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
  • Progesterone
  • Proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
  • Prucalopride
  • Quetiapine
  • Quinine
  • Raltegravir
  • Ranitidine
  • Rifabutin
  • Rifampin
  • Risperidone
  • Rivaroxaban
  • St. John's Wort
  • Sertraline
  • Silodosin
  • Sirolimus
  • Sitaxentan
  • Another "statin" anti-cholesterol medication (e.g., Lovastatin, Simvastatin etc.)
  • Tacrolimus
  • Teniposide
  • Tetracycline
  • Theophylline
  • Trazodone
  • Tyrosine kinase inhibitors (e.g., Bosutinib, Dasatinib, Imatinib, Nilotinib)
  • Zopiclone

Whilst these drugs are more likely to interact with Amlodipine and Atorvastatin, it is possible that other substances will interact as well.

A drug interaction will not automatically mean that the patient's treatment with this specific medication will be aborted, however. In some instances, doctors may simply alter the dose, advise patients to take their medication at a different time. Alternatively, doctors may continue with both treatments, unless unwanted side-effects become apparent.

Over-the-counter medications, alcohol, recreational drugs and even cigarettes can also interact with medications and affect how they work. If patients take any of these substances, it's important that they notify their physician. In doing so, they can obtain the safest and most effective form of treatment.

Warnings

Patients should not take this medication if they are allergic to any of the ingredients, particularly Amlodipine and/or Atorvastatin. All medications contain ingredients additional to the active substance. By checking the packaging, patients can ensure that they are not allergic to any fillers or binders which might be present.

Do not take Amlodipine and Atorvastatin if you are allergic to any medications in the same group. These may include, but are not limited to, Nicardipine, Nimodipine and/or Felodipine.

Patients should not consume grapefruit, grapefruit juice or products containing grapefruit while taking this medication.

Amlodipine and Atorvastatin should not be taken by patients who are pregnant. The medication can cause harm to unborn babies and may result in birth defects. An alternative medication should, therefore, be prescribed. Effective birth control should be used while taking this medication. If you become pregnant whilst taking Amlodipine and Atorvastatin, you should contact your physician immediately.

Similarly, patients who are breastfeeding should not be prescribed Amlodipine and Atorvastatin. It is unknown whether the medication could be passed to the infant via breastmilk and should not, therefore, be taken whilst breastfeeding.

Patients with diagnosed liver disease or abnormal liver function tests should not be prescribed this medication.
Amlodipine and Atorvastatin is not a suitable medication for patients with low blood pressure. As Amlodipine is designed to reduce blood pressure, taking this medication when you already have low blood pressure could have negative consequences.

If the patient exhibits an allergic reaction when taking this medication, urgent medical attention must be obtained. Symptoms of an allergic reaction to Amlodipine and Atorvastatin may include, facial swelling, difficulty breathing and/or hives.

Patients may need to stop taking Amlodipine and Atorvastatin if they have seizures, an imbalance of electrolytes, low blood pressure, surgery or a medical emergency and/or a severe infection or illness. In many cases, the medication will only need to be stopped temporarily. Patients should always seek medical advice before discontinuing or restarting treatment.

Patients may need to undergo regular blood tests while taking Amlodipine and Atorvastatin. By checking the patient's liver and kidney functions, physicians can ensure that the medication is not having an undesirable effect.

Avoid drinking alcohol whilst taking this medication. Consuming alcohol may raise triglyceride levels and could increase the risk of liver damage occurring. In addition to this, alcohol can cause your blood pressure to become lower. When consumed in addition to Amlodipine, your blood pressure could fall to a level which is considered to be too low.

If the patient has other medical conditions, it may affect whether they are able to take Amlodipine and Atorvastatin. Any of the following conditions may be a contra-indicator for treatment with this medication:

  • Alcohol abuse
  • Convulsions
  • Kidney disease
  • Coronary artery disease
  • Diabetes
  • Thyroid conditions
  • Heart conditions
  • Stroke or TIA

Whilst many patients with a history of these conditions will be able to take Amlodipine and Atorvastatin, physicians will assess their suitability on a case-by-case basis.

Storage

Amlodipine and Atorvastatin is normally prescribed in tablet form and can be kept by the patient at home. When storing medications in the home, however, it's important to ensure that no-one else has access to them.

If you have children or pets in your home, for example, you should keep medications, including Amlodipine and Atorvastatin, in a secure location.

The medication should be kept at room temperature and should also be kept away from heat, direct light, and moisture.

If you are advised to stop taking Amlodipine and Atorvastatin or if your medication is out of date, it should be disposed of properly. Patients are advised to seek help from their pharmacist when disposing of this medication.

Summary

High blood pressure and high levels of cholesterol are associated with a significant number of health problems. Patients may face increased risks of heart conditions, heart attacks, strokes and blocked arteries if they have untreated high blood pressure and/or high levels of cholesterol.

By taking medication to reduce blood pressure and cholesterol, patients can reduce the risk of further conditions developing or a medical emergency occurring.

As patients often need to take both Amlodipine and Atorvastatin, using a combination medication provides a simpler treatment regime. Rather than taking each medication individually, patients can simply take one tablet to treat both their high blood pressure and their high levels of cholesterol.

It should be noted, however, that these medications are normally used in conjunction with lifestyle changes. Doctors may advise patients to alter their diet and increase their exercise whilst taking Amlodipine and Atorvastatin. Whilst the medication can be extremely effective, it is likely to be most effective when patients adhere to the necessary lifestyle changes as well.

With numerous people facing heart problems and similar conditions, the use of Amlodipine and Atorvastatin is crucial in many cases. By helping to reduce the risk of life-threatening conditions, this medication can be life-saving when used in the appropriate circumstances.

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Last Reviewed:
December 10, 2017
Last Updated:
April 05, 2018