Moderate
Amlodipine × Morphine
Calcium channel blockers (dihydropyridines)×Natural opium alkaloids
Mechanism
Additive hypotension and sedation. Morphine reduces sympathetic tone; amlodipine dilates vessels. Older patients: fall risk.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
The combination is acceptable in palliative care and acute coronary syndrome. Titrate morphine from a low dose; monitor pulse, blood pressure, and saturation. Older patients: enhanced fall monitoring.