Introducing emergency dialysis will lead to significant outcomes in mortality and morbidity in patients with combined toxicity of amlodipine and metformin. Moreover, non-ST elevation myocardial infarction is also expected to be seen in such patients, which occurs as an outcome of amlodipine-mediated vasodilation. Therefore, there is a dire need for monitoring and managing cardiac complications as well.

Amlodipine is a dihydropyridine calcium channel blocker with the most prolonged half-life of its class at 30 to 50 hours.

The FDA-approved indications include hypertension, chronic stable angina, vasospastic angina, and coronary artery disease (CAD).

The mechanism of action involves inhibition of the voltage-gated L-type calcium channels, thereby lowering intracellular calcium, decreasing smooth muscle contraction, increasing smooth muscle relaxation, and vasodilation.

Side effects include refractory hypotension secondary to vasodilation, decreased chronotropy, tissue ischemia, subsequent lactic acidosis, and impaired pancreatic-islet insulin secretion.

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