From the Guidelines
Norvasc (amlodipine) should be prescribed at an initial dose of 5 mg once daily for hypertension and coronary artery disease, with a maximum dose of 10 mg daily, as recommended by the most recent guidelines 1.
Key Considerations
- For elderly patients or those with hepatic impairment, starting at 2.5 mg daily is recommended, as stated in the guidelines 1.
- The medication works by blocking calcium channels in blood vessels, causing them to relax and widen, which reduces blood pressure and improves blood flow to the heart.
- Patients should take Norvasc at the same time each day, with or without food, and should not stop taking it suddenly without consulting their healthcare provider.
Dosage and Administration
- Full antihypertensive effects typically develop within 1-2 weeks of consistent use.
- Common side effects include peripheral edema (swelling in ankles/feet), headache, and flushing.
- Norvasc can be used alone or combined with other antihypertensive medications for enhanced effect, as suggested by the British Hypertension Society guidelines 1.
Important Interactions
- Patients should inform their doctor about all other medications they're taking to avoid potential interactions, particularly with simvastatin, as Norvasc may increase its concentration in the blood.
- The dosage and combination therapy should be guided by the principles of additive effects on blood pressure and minimal side effects, as outlined in the guidelines 1.
Clinical Evidence
- The 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction recommends the use of calcium channel blockers, including amlodipine, for the management of hypertension and coronary artery disease 1.
- The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure provides a comprehensive overview of the treatment options for hypertension, including the use of calcium channel blockers like amlodipine 1.
From the FDA Drug Label
2 DOSAGE & ADMINISTRATION
2.1 Adults The usual initial antihypertensive oral dose of Amlodipine besylate tablets is 5 mg once daily, and the maximum dose is 10 mg once daily. Angina: The recommended dose for chronic stable or vasospastic angina is 5 to 10 mg, with the lower dose suggested in the elderly and in patients with hepatic insufficiency. Coronary artery disease: The recommended dose range for patients with coronary artery disease is 5 to 10 mg once daily.
The appropriate use and dosage of Amlodipine (Norvasc) for treating hypertension and coronary artery disease is:
- Initial dose: 5 mg once daily
- Maximum dose: 10 mg once daily
- Angina: dose range is 5 to 10 mg
- Coronary artery disease: dose range is 5 to 10 mg once daily 2
From the Research
Appropriate Use of Norvasc (Amlodipine)
- Norvasc (Amlodipine) is a calcium channel blocker used to treat hypertension and coronary artery disease 3, 4.
- It is considered a first-line antihypertensive agent due to its good efficacy and safety profile 4.
- Amlodipine has been shown to reduce the risk of stroke and myocardial infarction in hypertensive patients 3.
Dosage and Administration
- The dosage of Norvasc (Amlodipine) may vary depending on the patient's condition and response to treatment 5, 6.
- Combination therapy with other antihypertensive agents, such as angiotensin II receptor blockers or ACE inhibitors, may be recommended for patients with hypertension and coronary artery disease 5, 6.
- Fixed-dose single-pill combinations, such as irbesartan/amlodipine, may improve adherence and provide an easier regimen for patients 7.
Efficacy in Hypertension and Coronary Artery Disease
- Amlodipine has been shown to reduce the risk of major adverse cardiovascular events (MACEs) in patients with hypertension and coronary artery disease 5.
- Combination therapy with amlodipine and other antihypertensive agents may provide a more favorable effect on reducing cardiovascular events compared to monotherapy 5, 6.
- Amlodipine has been found to have a significant effect in reducing stroke and myocardial infarction in hypertensive patients, with a hazard ratio of < 1 for stroke (0.69-1.04) and MI (0.77-0.98) 3.