Moderate
Amlodipine × Nitroglycerin
Calcium channel blockers (dihydropyridines)×Organic nitrate
Mechanism
Additive hypotension with sublingual or parenteral nitroglycerin. Both drugs are vasodilators (amlodipine – calcium channel blocker, nitroglycerin – nitrate vasodilator).
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
The combination is acceptable in angina. The patient takes the first nitroglycerin dose sitting or lying down. Older patients: fall risk after nitroglycerin. Advise the patient to consult a clinician with frequent episodes.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.