Amlodipine is a CYP3A4 substrate and clarithromycin is a strong CYP3A4 inhibitor. Ethinyl Estradiol; Norgestrel: (Minor) Estrogen containing oral contraceptives can induce fluid retention and may increase blood pressure in some patients. Caution should be used when anti-retroviral protease inhibitors are coadministered with amlodipine; therapeutic response should be monitored. Maraviroc is a CYP3A substrate and amlodipine is a weak CYP3A4 inhibitor. Amlodipine is a weak inhibitor of CYP3A4, an isoenzyme partially responsible for the metabolism of dihydrocodeine. If coadministration is unavoidable, monitor blood pressure and heart rate. Nafcillin: (Minor) Coadministration of CYP3A4 inducers with amlodipine can theoretically increase the hepatic metabolism of amlodipine (a CYP3A4 substrate). NSAIDs cause a dose-dependent reduction in prostaglandin formation, which may result in a reduction in renal blood flow leading to renal insufficiency and an increase in blood pressure that are often accompanied by peripheral edema and weight gain. [29090] [64409] The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long-term care facilities. Caution should be used when diltiazem is coadministered with amlodipine; therapeutic response should be monitored. Prilocaine; Epinephrine: (Moderate) Antihypertensives, including calcium-channel blockers, antagonize the vasopressor effects of parenteral epinephrine. Coadministration of diltiazem (moderate CYP3A4 inhibitor) with amlodipine in elderly hypertensive patients resulted in a 60% increase in amlodipine systemic exposure. Oxycodone: (Moderate) Consider a reduced dose of oxycodone with frequent monitoring for respiratory depression and sedation if concurrent use of amlodipine is necessary. This effect is most significant in patients receiving concurrent antihypertensive agents and long-term NSAID therapy. Carbidopa; Levodopa; Entacapone: (Moderate) Concomitant use of antihypertensive agents with levodopa can result in additive hypotensive effects. Additive hypotensive effects are possible. Amlodipine is administered orally. When these drugs are given together, however, hypotension and impaired cardiac performance can occur, especially in patients with left ventricular dysfunction, cardiac arrhythmias, or aortic stenosis. Additive hypotensive effects are possible if ziprasidone is used concurrently with antihypertensive agents. Close monitoring of blood pressure is advised. Amlodipine is a CYP3A4 substrate and apalutamide is a strong CYP3A4 inducer. Amlodipine inhibits the influx of extracellular calcium across the myocardial and vascular smooth muscle cell membranes. Intravenous Lipid Emulsions: (Moderate) High doses of fish oil supplements may produce a blood pressure lowering effect. Amlodipine is a weak CYP3A4 inhibitor. Elderly patients may be at increased risk of adverse effects from combined long-term NSAID therapy and antihypertensive agents, especially diuretics, due to age-related decreases in renal function and an increased risk of stroke and coronary artery disease. Dexamethasone: (Minor) Coadministration of CYP3A4 inducers with amlodipine can theoretically increase the hepatic metabolism of amlodipine (a CYP3A4 substrate). Patients who rely upon renal prostaglandins to maintain renal perfusion may have acute renal blood flow reduction with NSAID usage. Doses of antihypertensive medications may require adjustment in patients receiving concurrent NSAIDs. No information is available on the quantitative effects of CYP3A inducers on amlodipine; however, concomitant use may result in decreased plasma concentrations of amlodipine. Ritonavir also prolongs the PR interval in some patients; however, the impact on the PR interval of coadministration of ritonavir with other drugs that prolong the PR interval (including calcium channel blockers) has not been evaluated. No information is available on the quantitative effects of CYP3A inducers on amlodipine; however, concomitant use may result in decreased plasma concentrations of amlodipine. and Privacy Policy and steps will be taken to remove posts identified Angioedema has been reported in patients taking mammalian target of rapamycin (mTOR) inhibitors in combination with amlodipine. Carbetapentane; Phenylephrine; Pyrilamine: (Moderate) Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Tenormin side effects The dosage requirements of amlodipine may be increased in patients receiving concurrent enzyme inducers. Taking these drugs together may increase carbamazepine plasma concentrations, potentially resulting in adverse events. If amlodipine dose adjustments are made, re-adjust the dose upon completion of telaprevir treatment. Atenolol; Chlorthalidone: (Moderate) Coadministration of amlodipine and beta-blockers can reduce angina and improve exercise tolerance. Doses of antihypertensive medications may require adjustment in patients receiving concurrent NSAIDs. There are many drug interactions that can potentiate the effects of antihypertensives. Ezetimibe; Simvastatin: (Major) Do not exceed a simvastatin dose of 20 mg/day in patients taking amlodipine due to increased risk of myopathy, including rhabdomyolysis. Coadministration has been associated with an increased risk of hypotension and shock. In addition, quinidine can decrease blood pressure and should be used cautiously in patients receiving antihypertensive agents due to the potential for additive hypotension. Worsening angina and acute myocardial infarction can develop after starting or increasing the dose of amlodipine, particularly in adult patients with severe obstructive coronary artery disease. Bexarotene: (Minor) Coadministration of CYP3A4 inducers with amlodipine can theoretically increase the hepatic metabolism of amlodipine (a CYP3A4 substrate). Monitor blood pressure and heart rate. Topiramate: (Minor) Coadministration of CYP3A4 inducers with amlodipine can theoretically increase the hepatic metabolism of amlodipine (a CYP3A4 substrate). If amlodipine is discontinued, monitor for evidence of opioid withdrawal; consider increasing the methadone dose if needed. Patients who rely upon renal prostaglandins to maintain renal perfusion may have acute renal blood flow reduction with NSAID usage. Carefully weigh the benefits of combined use of amlodipine and simvastatin against the potential risks. Caution should be used when CYP3A4 inducers, such as oxcarbazepine, are coadministered with amlodipine. Use of the forums is subject to our Terms of Use Theoretically, CYP3A4 inhibitors, such as anti-retroviral protease inhibitors, may increase the plasma concentration of amlodipine via CYP3A4 inhibition; this effect might lead to hypotension in some individuals. Answer this question. Particular caution should be used when prescribing avanafil to patients receiving concomitant CYP3A4 substrates, such as amlodipine. Niacin, Niacinamide: (Moderate) Cutaneous vasodilation induced by niacin may become problematic if high-dose niacin is used concomitantly with other antihypertensive agents, especially calcium-channel blockers. NSAIDs cause a dose-dependent reduction in prostaglandin formation, which may result in a reduction in renal blood flow leading to renal insufficiency and an increase in blood pressure that are often accompanied by peripheral edema and weight gain. Sulindac: (Moderate) If nonsteroidal anti-inflammatory drugs (NSAIDs) and an antihypertensive drug are concurrently used, carefully monitor the patient for signs and symptoms of renal insufficiency and blood pressure control. If amlodipine is discontinued, monitor the patient carefully and consider increasing the opioid dosage if appropriate. Taking these drugs together may increase tacrolimus plasma concentrations, potentially resulting in adverse events. Lidocaine; Prilocaine: (Moderate) Concomitant use of systemic lidocaine and amlodipine may increase lidocaine plasma concentrations by decreasing lidocaine clearance and therefore prolonging the elimination half-life. Amlodipine is a substrate of CYP3A4. Doses of antihypertensive medications may require adjustment in patients receiving concurrent NSAIDs. Fexofenadine; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by calcium-channel blockers. This effect is most significant in patients receiving concurrent antihypertensive agents and long-term NSAID therapy. Phenelzine: (Moderate) Additive hypotensive effects may be seen when monoamine oxidase inhibitors (MAOIs) are combined with antihypertensives. One study in patients with essential hypertension (n = 25) reported an average rise of 5 mmHg in mean blood pressure and a 66% increase in plasma norepinephrine (NE) concentrations following yohimbine administration (4 x 5.4 mg tablets PO).