This is a fixed-dose combination of amlodipine and metoprolol, two well-established medicines used together to treat high blood pressure (hypertension). It combines a calcium channel blocker with a beta-blocker, two different but complementary blood-pressure-lowering mechanisms, in a single tablet. It is a prescription-only medicine.

• Therapeutic Class: Antihypertensive combination therapy.

• Pharmacological Class: Dihydropyridine calcium channel blocker (amlodipine) combined with a selective beta-1 blocker (metoprolol).

• Drug Family: Combination cardiovascular therapy.

• ATC Classification: C07FB (Beta-blocking agents and calcium channel blockers); specific combination code varies by region.

• Approved/established use: Essential hypertension in adults, particularly when blood pressure is not adequately controlled on monotherapy with either component alone.

• Commonly used for: Patients with mild to moderate hypertension needing more than one blood-pressure-lowering mechanism, including some patients with hypertension and a history of coronary artery disease.

• Off-label use (only under medical guidance): Not typically used off-label; both individual components have long-established, broader cardiovascular uses (e.g., angina, certain heart rhythm conditions) that may factor into why this particular combination is chosen for a given patient.

Oral tablets/extended-release capsules: commonly available as metoprolol (extended-release) 25 mg/amlodipine 2.5 mg and metoprolol (extended-release) 50 mg/amlodipine 5 mg combinations.

Amlodipine relaxes and widens blood vessels by blocking calcium from entering smooth muscle cells in the vessel walls, reducing resistance to blood flow and lowering blood pressure. Metoprolol blocks beta-1 receptors, primarily in the heart, slowing the heart rate and reducing the force of heart contractions, which lowers blood pressure and reduces the heart's workload. Combined, the two medicines lower blood pressure through complementary mechanisms, often achieving better control than either alone.

• Standard dose: Metoprolol (extended-release) 25 mg/amlodipine 2.5 mg or metoprolol (extended-release) 50 mg/amlodipine 5 mg, taken orally once daily, with the specific strength chosen based on blood pressure response and tolerability.

• Condition-wise dose: Dose selection and any escalation between the two available strengths is guided by the treating doctor based on blood pressure readings over follow-up visits.

• Route: Oral, once daily, generally taken at a consistent time each day, with or without food (extended-release formulations should be swallowed whole and not crushed or chewed).

• Missed dose: Take as soon as remembered unless close to the next dose; don't double up.

• Overdose: Can cause excessive lowering of blood pressure and heart rate (hypotension, bradycardia); requires urgent medical attention.

• Common: Peripheral edema (ankle/leg swelling, linked to the amlodipine component), fatigue, dizziness, and slow heart rate (linked to the metoprolol component).

• Serious: Significant bradycardia (very slow heart rate), symptomatic low blood pressure, and, rarely, worsening of heart failure symptoms if present.

• Emergency symptoms: Fainting, severe dizziness, very slow or irregular heartbeat, chest pain, or significant swelling with shortness of breath.

• Recovery advice: Mild ankle swelling from the amlodipine component is common and often manageable; report any new or worsening shortness of breath, significant fatigue, or a notably slow pulse to the treating doctor.

• Pregnancy: Used only if clearly needed, under medical guidance; alternative antihypertensives are often preferred in pregnancy depending on individual circumstances.

• Breastfeeding: Discussed with the treating doctor given the presence of both components in breast milk to varying degrees.

• Liver disease: Used with caution; both components are metabolised by the liver, and dose adjustment may be needed in significant impairment.

• Kidney disease: Used with routine monitoring; amlodipine generally requires little adjustment, while metoprolol dosing may need review in significant impairment.

• Elderly: Commonly used in this age group; monitored for blood pressure and heart rate response, and for increased sensitivity to blood-pressure-lowering effects.

• Children: Not established for use in children; an adult hypertension medicine.

● Other beta-blockers or rate-lowering medicines (e.g., certain calcium channel blockers like verapamil/diltiazem, digoxin): combining can increase the risk of excessive heart rate or blood pressure lowering.

● Strong CYP3A4 inhibitors (e.g., ketoconazole, certain antifungals): can increase amlodipine levels.

● CYP2D6 inhibitors (e.g., certain SSRIs, quinidine): can increase metoprolol levels, since metoprolol is metabolised through this enzyme pathway.

● NSAIDs: may reduce the blood-pressure-lowering effect of both components when used regularly.

● Blood pressure checks regularly to assess control.

● Heart rate monitoring, particularly when starting or adjusting the dose.

● Assessment for ankle/leg swelling and signs of fluid retention.

● Periodic review of kidney and liver function, particularly in patients with pre-existing conditions.

Amlodipine or metoprolol used as separate individual tablets, allowing more flexible dose titration of each component; other antihypertensive combinations (e.g., ACE inhibitor/calcium channel blocker) depending on individual patient factors.

This is a fixed combination of two blood-pressure medicines; the treating doctor may add additional antihypertensive agents (e.g., diuretics, ACE inhibitors/ARBs) if blood pressure remains uncontrolled on this combination alone.

● Hypertension Medicines

● Calcium Channel Blockers

● Beta-Blockers

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1. https://pubmed.ncbi.nlm.nih.gov/22352120/

2. https://pubmed.ncbi.nlm.nih.gov/24672188/

The information on this page is for educational purposes only and is not a substitute for medical advice. Please consult your doctor to know if this treatment is appropriate for your condition.