Why Amlodipine Causes Ankle Swelling and How to Reduce It

Amlodipine, sold as a generic drug or as the Katerzia and Norvasc brands, often causes ankle edema. This is an abnormal swelling of tissues due to fluid buildup. Swollen feet are a common side effect experienced by about 16% of people who use it, according to a 2019 study.

Amlodipine is a calcium channel blocker, a medication used to treat hypertension (high blood pressure) and angina (heart-related chest pain). It relaxes blood vessels and decreases blood pressure, making it easier for your heart to pump blood throughout the body. Its effects also make it easier for the swelling to occur.

Why Amlodipine Causes Ankle Swelling

Amlodipine and other calcium channel blockers cause blood vessels to dilate. The dilation, in turn, lowers the blood pressure and improves blood flow throughout the body.

However, the improved blood flow can increase the pressure within smaller blood vessels called capillaries. This can cause fluids to seep through the walls of the vessels into surrounding tissues.

The risk of edema is largely dose-dependent, meaning that higher doses of amlodipine correspond to a greater likeliness (or the worsening) of symptoms. For example, reported rates of edema at a dose of 2.5 milligrams (mg) were 1.8%. That jumped to 10.8% at 10 mg doses. 

The likelihood of edema increases the longer you take amlodipine. In one study, people who took amlodipine for five years or more were 20 times more likely to experience swelling as a side effect. Edema from amlodipine is also more common in females than males.

How to Ease Ankle Swelling from Amlodipine

Edema from amlodipine can often be managed with at-home strategies. Your healthcare provider may recommend taking your medication at night instead of in the morning if swelling is a problem.

To ease foot and ankle swelling, you can:

• Avoid prolonged standing or sitting.
• Elevate your feet above your heart. 
• Get up and walk around to keep fluid circulating.
• Choose low heel, wide, and soft-soled shoes.

You also can:

• Make sure you drink enough water—dehydration can prompt the body to retain excess fluid. 
• Massage your feet and legs to promote circulation.
• Soak your feet, ankles, and calves in Epsom salts to draw out fluid.
• Wear compression socks to prevent fluid from collecting in your feet and ankles.

Other Side Effects

In addition to swelling, other side effects of amlodipine include:

• Dizziness or lightheadedness
• Drowsiness
• Excessive tiredness
• Flushing
• Headache
  
• Nausea
• Stomach pain
• Upset stomach

Amlodipine can also have more serious side effects. If you experience any of the following, contact your healthcare provider:

• Fainting
• More frequent or more severe chest pain
• Rapid, pounding, or irregular heartbeat

Amlodipine Overdose Warning

It is possible to overdose on amlodipine and other calcium channel blockers. Never take more than the recommended dose. Signs of overdose include:

• Constipation
• Confusion
• Drowsiness
• Slowed heartbeat
• Slurred speech
• Shortness of breath
• Weakness
• Nausea
• Increased blood sugar

If an overdose is suspected, call the Poison Control Hotline at 1-800-222-1222, available 24 hours, seven days a week. Do not induce vomiting unless a trained poison control professional tells you to do so.

When to Call Your Healthcare Provider

If you experience edema while taking amlodipine, tell your healthcare provider. Do not stop treatment without discussing it first. You may need additional tests to rule out other conditions that can cause your ankles to swell, such as pulmonary hypertension.

To manage edema, your healthcare provider may lower the dose, change your medication, or add another medication:

• Diuretics (water pills) are often prescribed alongside amlodipine. However, diuretics are not always effective for relieving edema as a side effect of amlodipine.
• An ACE inhibitor or angiotensin II receptor blocker may be added to your medications. If you're already taking these medications, you may be given a higher dose.

Your healthcare provider may also prescribe a different calcium channel blocker, such as diltiazem, lacidipine, lercanidipine, or verapamil, or switch you to another class of drugs.

Summary

Amlodipine is a calcium channel blocker used to treat high blood pressure and angina. Edema, or the abnormal swelling of tissue due to fluid build-up, is a side effect. Although foot and ankle swelling is common, the hands and lower legs may also experience swelling.

Tell your healthcare provider about any edema. You may be switched to another medication, or the amlodipine dose may simply be reduced to see if that helps. Never stop or alter treatment without first speaking to your healthcare provider.