Nifedipine Equivalent to Amlodipine 10 mg
The equivalent dose of extended-release nifedipine to amlodipine 10 mg is 60-90 mg once daily. This conversion is based on clinical evidence and established guidelines for calcium channel blockers in hypertension management.
Dose Equivalence Rationale
The dose equivalence between these two dihydropyridine calcium channel blockers can be determined by examining their pharmacological profiles and clinical dosing information:
- Amlodipine 10 mg is considered a maximum daily dose for hypertension treatment 1
- Extended-release nifedipine has a dosing range of 30-90 mg daily, with 60-90 mg being comparable to maximum amlodipine dosing 1
Supporting Evidence
- According to the ACC/AHA guidelines, amlodipine's usual dose range is 2.5-10 mg once daily, while extended-release nifedipine's range is 30-180 mg once daily 1
- Clinical studies comparing these medications have shown that:
- Amlodipine 5-10 mg once daily provides similar blood pressure control to nifedipine extended-release 20 mg twice daily (40 mg total) 2
- When converting from nifedipine extended-release to amlodipine, patients typically require 5-10 mg of amlodipine to maintain blood pressure control 3
- In comparative trials, amlodipine 10 mg was equivalent to nifedipine GITS (gastrointestinal therapeutic system) 60 mg for 24-hour blood pressure control 4
Clinical Considerations
When converting between these medications, consider these important differences:
- Duration of action: Amlodipine has a significantly longer half-life (30-50 hours) compared to even extended-release nifedipine formulations 1
- Dosing frequency: Amlodipine requires once-daily dosing, while some nifedipine formulations may require twice-daily administration 1
- Formulation matters: Only use extended-release nifedipine formulations (coat-core, GITS, or other sustained-release preparations) for this conversion, as immediate-release nifedipine has different pharmacokinetics and safety concerns 1
Important Cautions
- Immediate-release nifedipine should be avoided due to risk of reflex tachycardia and potential for adverse cardiovascular events 1
- Nifedipine extended-release tablets must be swallowed whole and cannot be crushed or split 1
- When switching between these medications, close blood pressure monitoring is recommended as individual response may vary
In summary, when converting from amlodipine 10 mg to extended-release nifedipine, start with 60 mg once daily and titrate to 90 mg if needed for equivalent blood pressure control.