Is amlodipine a nitrate? | Detailed Explanation

Amlodipine is a long-acting antihypertensive drug that helps maintain blood pressure levels throughout the day, for approximately 24 hours. It is the first nonsteroidal anti-inflammatory drug approved for the treatment of hypertension. Amlodipine has been widely used in clinics due to its safety, minimal side effects, and remarkable therapeutic efficacy. Is amlodipine a nitrate or not? Come and study with me.

What is amlodipine?

Amlodipine belongs to the third generation of CCB(Calcium Channel Blockers (CCBs), with a half-life of up to 30-50 hours. The patient only needs to take it once a day to realize more than 24 hours of lasting and smooth blood pressure reduction. It effectively covers both early morning and nighttime blood pressure, making it more suitable for the routine treatment of hypertension.

What are nitrate drugs?

Speaking of hypertension and angina pectoris, another common medical treatment is nitrate drugs. The main nitrate drugs used clinically are nitroglycerin, isosorbide nitrate, and its metabolite isosorbide mononitrate. Nitrate drugs have vasodilating effects, can inhibit platelet aggregation and adhesion, and have anti-thrombotic properties. They are beneficial in the treatment of angina pectoris caused by coronary atherosclerosis. Angina pectoris is a common symptom of coronary heart disease. Angina pectoris is a common symptom of coronary heart disease, caused by acute, temporary ischemia and hypoxia of the heart muscle, the attack usually lasts for several minutes and can be relieved by rest or treatment with medication.

Common clinical nitrate drugs include nitroglycerin, isosorbide nitrate, isosorbide mononitrate, and pentylenetetrazol. This class of drugs has similar effects, of which the current clinical application of more is mainly: nitroglycerin, isosorbide nitrate, and isosorbide mononitrate.

The Differences Between Amlodipine and Nitrate Drugs

1. Mechanism of Action

which works by blocking the entry of calcium ions into the smooth muscles of blood vessels and the heart. By doing so, it helps to dilate the peripheral arteries and reduce resistance in the blood vessels, ultimately leading to a decrease in blood pressure.

Nitrates can bind to nitrate receptors in smooth muscle cells and be reduced to N0 or -SN0 by the sulfhydryl groups of nitrate receptors. The released nitric oxide could make blood vessels diastolic also inhibit platelet aggregation and adhesion, exerting a therapeutic effect on coronary angina pectoris. 

2. Therapeutic Effect

Amlodipine tablets have a longer efficacy, which can keep the efficacy in the human body for about 35 hours, so patients can achieve the effect of lowering blood pressure by taking 1 tablet of the drug every day. Amlodipine tablets have a good therapeutic effect on elderly patients with high blood pressure, which can make the blood pressure of the elderly fall smoothly; patients who like to drink alcohol can also have their blood pressure lowered smoothly, which is a kind of better antihypertensive drug.

On the other hand, nitrates enter smooth muscle cells and decompose into nitric oxide. This process relaxes the smooth muscle by releasing calcium ions from cells, which in turn expands coronary arteries and collateral circulation vessels. As a result, blood supply to ischemic areas, particularly the subendocardium, is increased. It can also reduce myocardial oxygen consumption and improve cardiac function.

3. Indications

Both two medicines can be used for angina pectoris, coronary heart disease, heart failure, and hypertension. In clinical practice， nitrates are primarily used to minimize the frequency and severity of angina, which is also a common choice when amlodipine is ineffective.

The drug half-life of amlodipine is more than 24 hours, so it can be very effective to continue to lower blood pressure. After a long period, even if you miss a dose, your blood pressure will not fluctuate greatly. Of course, it is best not to miss a dose.

Conclusion

Is amlodipine a nitrate? The answer is NO. In terms of the size of side effects, amlodipine may be better as it has fewer side effects. Nevertheless， nitrate drugs have a stronger effect. Both are calcium channel blockers and are widely used in clinical practice. Amlodipine has a longer half-life and a milder effect, which is suitable for elderly patients with hypertension and those with large blood pressure fluctuations. Side effects such as lower limb edema, facial flushing, and headaches are less likely to occur in patients who have amlodipine. Therefore, the choice of antihypertensive medication should be personalized based on different individuals and blood pressure conditions.