From the Guidelines
The recommended initial dose of Norvasc (amlodipine) for treating hypertension or coronary artery disease is 5 mg once daily, with a maximum daily dose of 10 mg, as supported by the most recent evidence from 1. For elderly patients or those with hepatic insufficiency, starting with a lower dose of 2.5 mg daily is advised. Dose titration should be gradual, allowing 7-14 days between dose increases to reach optimal effect, as amlodipine has a long half-life and takes time to reach steady-state plasma concentrations. When adjusting the dose, monitor blood pressure response and watch for side effects such as peripheral edema, headache, or dizziness. Amlodipine works by blocking calcium channels in vascular smooth muscle and cardiac muscle, leading to vasodilation and reduced peripheral resistance, which explains its effectiveness in lowering blood pressure. The medication can be taken with or without food, and its once-daily dosing helps improve patient adherence to the treatment regimen.
Some key points to consider when using amlodipine include:
- Monitoring blood pressure regularly to assess the effectiveness of treatment and adjust the dose as needed
- Watching for side effects such as peripheral edema, headache, or dizziness, and adjusting the dose or adding other medications as needed to manage these side effects
- Considering the use of amlodipine in combination with other medications, such as ACE inhibitors or beta blockers, to achieve optimal blood pressure control
- Being aware of potential interactions between amlodipine and other medications, such as grapefruit juice or certain antibiotics, and adjusting the dose or monitoring for side effects as needed.
It's also important to note that amlodipine is a commonly used medication for the treatment of hypertension and coronary artery disease, and has a well-established safety and efficacy profile, as supported by evidence from 1, 1, 1, 1, and 1. However, the most recent and highest quality evidence from 1 should be prioritized when making treatment decisions.
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. 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. Adjust dosage according to blood pressure goals. In general, wait 7 to 14 days between titration steps. Titrate more rapidly, however, if clinically warranted, provided the patient is assessed frequently 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. Most patients will require 10 mg for adequate effect. Coronary artery disease: The recommended dose range for patients with coronary artery disease is 5 to 10 mg once daily. In clinical studies, the majority of patients required 10 mg [see Clinical Studies (14. 4)] .
The recommended initial dose of Norvasc (amlodipine) for treating hypertension is 5 mg once daily, with a maximum dose of 10 mg once daily. For coronary artery disease, the recommended dose range is 5 to 10 mg once daily.
- The initial dose for small, fragile, or elderly patients, or patients with hepatic insufficiency is 2.5 mg once daily.
- Titration should be done according to blood pressure goals, with a wait of 7 to 14 days between titration steps 2.
- The dose may be titrated more rapidly if clinically warranted, provided the patient is assessed frequently.
- For angina, the recommended dose is 5 to 10 mg, with the lower dose suggested in the elderly and in patients with hepatic insufficiency.
From the Research
Norvasc (Amlodipine) Dosage
- The recommended initial dose of Norvasc (amlodipine) for treating hypertension is 5 mg once daily, with a possible titration to 10 mg if necessary 3.
- For patients with coronary artery disease, the dosage may vary, but 5-10 mg once daily is a common range 4.
Titration and Combination Therapy
- Titration of amlodipine may be necessary to achieve optimal blood pressure control, with doses ranging from 5 to 10 mg once daily 3, 5.
- Combination therapy with other antihypertensive agents, such as benazepril, atorvastatin, or perindopril, may be effective in achieving blood pressure targets and reducing cardiovascular risk 5, 4, 6.
- Triple combination therapy with a statin, ACE inhibitor, and calcium channel blocker, such as atorvastatin, perindopril, and amlodipine, may be associated with a significant reduction in major cardiovascular events 6.
Efficacy and Safety
- Amlodipine has been shown to be an effective and well-tolerated antihypertensive agent, with a low incidence of adverse events 3, 5.
- Long-term use of amlodipine has been associated with no tolerance and a low risk of adverse effects 3.
- Amlodipine should be considered a first-line antihypertensive agent due to its efficacy and safety profile 7.