Amlodipine

Important safety and use flags

• Do not treat a single high in-clinic reading as persistent hypertension. Unless acute ocular or neurologic target-organ damage makes delay unsafe, use a standard low-stress technique and confirm elevated systolic pressure on different days before starting chronic treatment.
• Identify and treat contributing disease such as CKD, hyperthyroidism, diabetes or hyperaldosteronism, and examine the fundus, neurologic status, heart and kidneys for target-organ damage. Amodip controls pressure; it does not replace disease-specific care.
• Use the exact starting table: 2.5-5.0 kg half a tablet, 5.1-10.0 kg one tablet, and 10.1 kg or more two tablets once daily. This presentation cannot accurately dose cats under 2.5 kg. Do not start at the 0.5 mg/kg ceiling.
• Recheck systolic pressure after 14 days. Double or increase up to 0.5 mg/kg once daily only if SBP remains above 150 mmHg or has fallen by less than 15%; thereafter monitor routinely, commonly every 6-8 weeks, and avoid excessive hypotension.
• Monitor appetite, vomiting, diarrhoea, hydration, lethargy, weight, oral tissues, potassium and chloride. Gingival hyperplasia is dose- and time-related; clinically important hyporexia, dehydration, weakness, hypotension or oral disease requires reassessment rather than automatic continuation.
• Do not use in cardiogenic shock, severe aortic stenosis, severe hepatic failure or amlodipine/excipient hypersensitivity. In lesser hepatic disease use a documented benefit-risk decision because amlodipine is extensively metabolised by the liver.
• Other antihypertensives, diuretics, RAAS inhibitors, vasodilators and alpha-2 agonists can add hypotension. Beta-blockers, cardioselective calcium-channel blockers and azole antifungals can also reduce cardiac rate or contractility; review hydration, BP and ventricular function before combining.
• Safety is not established in cardiac failure, pregnancy or lactation. Use in these groups only after an explicit veterinary benefit-risk assessment; do not infer reproductive safety from rodent data or routine safety in stable hypertensive geriatric cats.
• Give directly or with only a small amount of food and confirm the full dose is swallowed. Return the unused half to its blister, use it within 24 hours and keep the flavoured tablets away from animals and children; accidental ingestion can cause clinically important hypotension.
• Acute blindness, retinal detachment/haemorrhage or neurologic signs with severe hypertension is urgent target-organ damage. Prompt BP control may reattach retina or improve lesions, but established severe retinal degeneration and vision loss can remain irreversible.