From the Guidelines
Amlodipine is typically started at 5 mg once daily for adults with hypertension, with the option to increase to a maximum dose of 10 mg once daily if blood pressure control is inadequate after 1-2 weeks. This dosing regimen is based on the most recent and highest quality study available, which prioritizes morbidity, mortality, and quality of life as the outcome 1.
Key Considerations
- For elderly patients or those with hepatic impairment, a lower starting dose of 2.5 mg once daily is recommended.
- Amlodipine can be taken with or without food, and is usually administered at the same time each day to maintain consistent blood levels.
- The full antihypertensive effect generally develops over 1-2 weeks of treatment.
- Amlodipine works by blocking calcium channels in vascular smooth muscle cells, causing vasodilation and reducing peripheral resistance, which lowers blood pressure.
- Side effects may include peripheral edema, headache, and flushing.
- Patients should be advised that abrupt discontinuation should be avoided, and that consistent daily dosing is important for maintaining blood pressure control.
- Amlodipine can be used as monotherapy or in combination with other antihypertensive medications when additional blood pressure reduction is needed.
Additional Benefits
- Amlodipine may have renoprotective effects in patients with chronic kidney disease (CKD), especially when paired with angiotensin receptor blockers (ARBs) 1.
- A single dose of amlodipine can lead to a demonstrable increase in estimated glomerular filtration rate (eGFR) in CKD patients 1.
From the FDA Drug Label
The usual initial antihypertensive oral dose of Amlodipine besylate tablets is 5 mg once daily, and the maximum dose is 10 mg once daily. Small, fragile, or elderly patients, or patients with hepatic insufficiency may be started on 2.5 mg once daily and this dose may be used when adding Amlodipine besylate tablets to other antihypertensive therapy.
The starting dose of amlodipine for patients with hypertension is typically 5 mg once daily. However, for small, fragile, or elderly patients, or patients with hepatic insufficiency, the starting dose may be 2.5 mg once daily 2.
- The dose can be adjusted according to blood pressure goals.
- The maximum dose is 10 mg once daily.
From the Research
Typical Dosing Regimen for Amlodipine
- The typical starting dose of amlodipine for patients with hypertension is 5 mg once daily, with the option to adjust to 10 mg if necessary 3.
- Amlodipine can be used as a first-line agent for improving blood pressure and patient outcomes, with efficacy for reducing cardiovascular events 4.
- The medication has been shown to be well-tolerated and effective in various patient populations, including those with concomitant diabetes and/or renal dysfunction 5.
Key Considerations
- Amlodipine can produce important additional antihypertensive effects when used in combination with other agents, such as angiotensin-converting enzyme inhibitors, beta-blockers, or thiazide diuretics 3.
- The medication has been compared to other classes of antihypertensive agents, including diuretics, beta-blockers, and angiotensin II receptor blockers, with similar efficacy in reducing blood pressure and cardiovascular events 5.
- Amlodipine has also been shown to have potential benefits beyond blood pressure reduction, including alleviating non-alcoholic fatty liver disease by modulating gut microbiota 6.