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Pharmaceuticals2026-06-13 · 8 min read

Amodip (Amlodipine) for Cats: The First FDA-Approved Feline Amlodipine, Explained

Amodip (amlodipine besylate tablets), approved April 2026, is the first FDA-approved amlodipine for cats. Dosing, monitoring, and when amlodipine is not the whole answer.

Ran Chen
Ran Chen
Founder, VetMedGuide. Life-sciences operator and 10× global market-access lead.
Published

For roughly two decades, amlodipine has been the de facto first-line drug for high blood pressure in cats — prescribed off-label from human tablets split into quarters, or from compounded formulations, because no veterinary-specific product existed in the United States. That changed on April 29, 2026, when the FDA approved Amodip (amlodipine besylate chewable tablets), sponsored by Ceva Santé Animale. Amodip is the first amlodipine product approved for veterinary use and only the second drug ever FDA-approved to control systemic hypertension in cats, after Semintra (telmisartan oral solution) in 2018.

The molecule is not new. What is new is the formulation, the labeling, and the dosing precision it brings to a condition where both matter a great deal. This article explains where amlodipine fits in the management of feline hypertension, what the Amodip approval changes, and the cases where it is — and is not — the right tool.

Why feline hypertension is worth catching

Systemic hypertension in cats is usually silent until it causes damage. Systolic blood pressure (SBP) rises with age — the average age at diagnosis is around 14 years — and the condition most often develops secondary to chronic kidney disease (CKD) or hyperthyroidism, though it can also be idiopathic. When blood pressure stays elevated, it injures the highly perfused organs: the eyes (retinal hemorrhage and detachment, sometimes sudden blindness), the kidneys (accelerating CKD), the heart (left ventricular wall thickening), and the brain and central nervous system.

The 2018 ACVIM consensus statement on systemic hypertension in dogs and cats grades risk by systolic pressure:

ACVIM 2018 category Systolic BP (mmHg) Target-organ-damage risk
Normotensive < 140 Minimal
Prehypertensive 140–159 Low
Hypertensive 160–179 Moderate
Severely hypertensive ≥ 180 High

That framework is the reference point for deciding whether to treat: a single SBP above 160 mmHg with documented target-organ damage warrants immediate treatment, while borderline readings without damage should be reconfirmed on separate visits before starting a drug.

Why amlodipine is the first-line choice

Amlodipine is a dihydropyridine calcium channel blocker. It blocks L-type calcium channels in vascular smooth muscle, relaxing the vessel wall and lowering peripheral resistance. In cats it is effective, once-daily, and well tolerated — which is why the ACVIM consensus names calcium channel blockers, specifically amlodipine besylate, as the first-choice antihypertensive agent for idiopathic hypertension and hypertension associated with CKD. Published studies report a mean SBP decrease of roughly 28–55 mmHg in hypertensive to severely hypertensive cats.

Until Amodip, that first-line drug was only available off-label. The practical consequences were real: a human 2.5 mg tablet split into quarters to approximate a 0.625 mg cat dose introduces dosing inaccuracy, and compounded liquids can carry stability and concentration-variability questions. None of this prevented effective use — amlodipine worked off-label for years precisely because it is a good feline antihypertensive — but it left prescribers without a species-specific, FDA-vetted option.

What the Amodip approval adds

Amodip's effectiveness was established in a masked, placebo-controlled field study in 77 client-owned cats with systemic hypertension (defined as SBP ≥160 mmHg and diastolic ≥100 mmHg). At day 28, 64.1% of treated cats met the primary effectiveness criterion, versus 17.6% of controls, and the treated group achieved a mean SBP reduction of 28.2 mmHg from baseline compared with 9.9 mmHg in controls. Additional support came from a one-year, open-label study in 225 cats that found improvement in ophthalmic fundic lesions — a marker of hypertensive target-organ damage. One important caveat from that dataset: cats that began treatment with severe vision loss were less likely to regain visual function, even when retinal detachment improved. Early treatment, before target-organ damage is established, is where the drug earns its keep.

Dosing: the part the approval actually changes

Amodip is dosed once daily by body weight, with a standard starting dose and a higher dose used after 14 days if the response is inadequate:

Cat weight Standard dose (start) High dose (after 14 days)
2.5–5.0 kg 0.5 tablet (0.625 mg) 1 tablet (1.25 mg)
5.1–10 kg 1 tablet (1.25 mg) 2 tablets (2.5 mg)

This maps onto the long-standing clinical convention — start at 0.625 mg per cat and titrate up to 1.25 mg — but now in a scored chewable tablet designed for accurate feline dosing. The label notes that cats under 2.5 kg cannot be accurately dosed with Amodip, a real constraint for small patients where a liquid (such as compounded amlodipine or telmisartan oral solution) may be more appropriate. Half tablets should be returned to the blister pack and given the next day.

The treatment goal is an SBP below 160 mmHg, with a blood-pressure recheck roughly one to two weeks after starting or adjusting the dose. Bloodwork should be checked early in treatment for changes in kidney and liver values, and owners should watch for reduced appetite, vomiting, or diarrhea — signs that can indicate the dose is more than the cat needs. Once blood pressure is stable, cats are usually rechecked about every three months, and the dose should be lowered if SBP falls below roughly 120 mmHg or the cat shows weakness or lethargy from hypotension. One uncommon but recognized adverse effect of amlodipine is gingival overgrowth (gingival hyperplasia); it is dose-related and typically resolves when the drug is stopped or the dose reduced, and it is something to watch for at oral exams rather than a reason to avoid amlodipine in most cats.

In a hypertensive emergency — a cat presenting with acute blindness, retinal detachment, or neurologic signs such as seizures — amlodipine is still the preferred first agent and may be repeated within the first 24 hours (up to a practical total of about 2.5 mg) under veterinary direction, rather than waiting on a slower-acting option.

When amlodipine is not the whole answer

Amlodipine is excellent first-line therapy, but feline hypertension is often part of a larger picture, and a single drug does not always get a cat to target.

  • Refractory hypertension. When SBP stays at or above 160 mmHg after at least a week on amlodipine, options are to increase the amlodipine dose (up to a practical ceiling around 2.5 mg/day) or to add a RAAS inhibitor — typically telmisartan or, less potently, benazepril. Benazepril's antihypertensive effect in cats is mild enough that it is not recommended as first-line, but it has a role as add-on therapy.
  • CKD with proteinuria. Many hypertensive cats already have CKD, and telmisartan (Semintra) is approved both for hypertension and for reducing proteinuria in feline CKD. Amlodipine is well tolerated across all CKD stages and does not by itself worsen kidney function, but by relaxing the vessels it can activate the renin-angiotensin-aldosterone system (RAAS) — the same system that drives proteinuria and kidney scarring. In a proteinuric, hypertensive cat the two drugs are therefore often used together rather than as either/or: amlodipine as the blood-pressure workhorse, telmisartan for its renal-protective, anti-proteinuric effect on the RAAS pathway.
  • Small cats. For cats under 2.5 kg, the tablet cannot be dosed accurately; a liquid formulation is the better route.
  • Over-treatment. A cat that becomes inappetent, lethargic, or hypotensive on a dose may need the dose reduced — the same vigilance that applies to any antihypertensive.

The larger point: measure before you treat

Amlodipine — now, finally, in an approved feline formulation — is a safe and effective first-line drug. But the drug only does its job if hypertension is found before it blinds the cat. Because SBP climbs with age and the condition is asymptomatic early on, routine blood-pressure screening in mature and senior cats (commonly from around 7–9 years of age, and annually thereafter), with reliable measurement technique and a proper cuff, is what makes an antihypertensive worthwhile. Amodip fills the long-standing formulation gap; the screening is what determines whether a cat reaches it in time.

Sources

Topics
CardiologyFeline CKD
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