Scooter's Supplies for Chronic Renal Failure (CRF)

About Amlodipine Besylate (Brand Name - Norvasc)


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Norvasc (Amlodipine Besylate) for Feline Hypertension: US vets consider amlodipine, a prescription calcium channel blocker, the most effective treatment for feline hypertension.  (ACE inhibitors such as enalapril and benazepril are considered the most effective hypertension treatment for dogs.)  Most vets start treatment for feline hypertension as soon as blood pressure readings are consistently 175 or above (systolic).  Some vets are beginning to treat CRF cats even earlier --  when pressure readings are consistently over 165 or even 155!  The usual protocol is to start treatment with .625 milligrams (mg) of Norvasc per day, then check pressure again in 5 - 10 days.  If pressure is still high (generally over 155-160), the dose is increased to 1.25 mg of Norvasc.  Goal is to have the pressure consistently at 155 or below - any higher might lead to ocular damage.  If 1.25 mg of Norvasc isn't effective, most vets either increase the Norvasc dosage again or add an ACE inhibitor.

Amlodipine Besylate is available in 2.5, 5 and 10 mg tablets, both generic and brand name (Norvasc).  Most (but not all) generic pills are round while the brand name 2.5 mg pills are diamond-shaped, the brand name 5 mg pills are octagonal and the brand name 10 mg pills are round.  Since the generics are far cheaper and the round generics are far easier to cut into cat-sized doses than the brand name pills, I recommend the generic in all cases.

The pricing of Amlodipine Besylate is somewhat unusual - 2.5 mg and 5 mg pills cost about the same and the 10 mg pills cost just a little more.  Since cat doses are usually .625 mg and 1.25 mg and rarely 2.5 mg, you most likely will have to take a pill cutter, razor or other device to Amlodipine Besyltate tabs to generate the right dose.  The size tablets you buy will depend on both price and your ability to cut or break pills into smaller-sized doses.  Most will feel comfortable quartering a round pill but dividing a pill into eighths will challenge most and dividing a pill into sixteenths is well nigh impossible.  Only a few feel very comfortable dividing 10 mg pills into eighths and even tenths (1 mg doses) with pill cutter, razor blade and even two tweezers used to "break" each tab into progressively smaller pieces.  The good news is that dramatic price reductions following the introduction of generics has almost completely removed the economic incentive cut 10 mg pills into eighths or tenths.

The table below was developed using the 3/15/08 prices from COSTCO Online for the generic Amlodipine Besylate.  Based on those prices and the analysis below:

  1. Most will start with the 2.5 mg pills and then move to higher milligram pills once the dosage that controls their cat's hypertension is well established.
  2. It is advantageous to buy the highest milligram pill that you can easily divide into the required dose for your cat.  But potential savings are much reduced as generic prices continue to decline and many will choose convenience over saving a few bucks.
  3. It is advantageous to buy more than 30 pills at a time.

Amlodipine Besylate -- COSTCO Online (3/15/08)

$ Per Dose

$ Per Year

# of pills

$ for 2.5 mg pills

$ Per Pill

0.625 mg

1.25 mg

2.5 mg

0.625 mg

1.25 mg

2.5 mg

30

$5.69

$.19

$.05

$.09

$.19

$17.31

$34.61

$69.23

50

$7.13

$.14

$.04

$.07

$.14

$13.01

$26.02

$52.05

100

$10.86

$.11

$.03

$.05

$.11

$9.91

$19.82

$39.64

 

$ for 5.0 mg pills

 

 

 

 

 

 

 

30

$5.82

$.19

$.02

$.05

$.10

$8.85

$17.70

$35.41

50

$7.53

$.15

$.02

$.04

$.08

$6.87

$13.74

$27.48

100

$11.46

$.11

$.01

$.03

$.06

$5.23

$10.46

$20.91

 

$ for 10 mg pills

 

 

 

 

 

 

 

30

$6.12

$.20

xxxx

$..03

$.05

xxxx

$9.31

$18.62

50

$7.94

$.16

xxxx

$.02

$.04

xxxx

$7.25

$14.49

100

$12.37

$.12

xxxx

$.02

$.03

xxxx

$5.64

$11.29

Costco Online Shipping is free for USPS delivery.

Last, for those who don't want to hassle with cutting up pills, compounding pharmacies will do it for you, enclosing the right sized doses in capsules.  It costs a little more but you have the comfort of knowing that your cat is getting the exact dose prescribed.

Editor's Note: 

Why Norvasc?  I've avoided analyses of prescription drug pricing on this site because most drugs are readily available from local and on-line pharmacies and because best price search engines are available to analyze on-line pharmacy pricing.  But our 18-year-old Tuxedo Cat, Scooter, came up blind on a Saturday night in late May 2003.  Fortunately, we had read that sudden onset blindness is often the first indication of feline hypertension and quickly got Scooter on Norvasc and he quickly regained most of his sight.  Having done the research on Norvasc, I wanted to share it with everyone else ... I've just updated this page to incorporate the March 2008 pricing of the new generic.  The cost savings from buying higher milligram pills is now minimal and I expect that most will now choose to buy the 2.5 mg pills because they are easier to cut into cat-sized doses.

David Jacobson
Arlington, VA 

 

This page is the product of me, David Jacobson. The information presented here is not guaranteed.  Contact the vendors listed directly for their current prices and policies.  Feel free to link this page to other pages and web sites dealing with the medical treatment of cats and dogs.  And please contact me with any updated information or additional vendors, or your comments, criticisms and suggestions.  I appreciate your help.

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