From the Guidelines
Amlodipine should be initiated at a dose of 5 mg daily for the treatment of hypertensive urgency in antihypertensive-naive patients with excessively high blood pressure, according to the most recent evidence. When considering the management of hypertensive urgency, it is crucial to prioritize the patient's safety and the potential for end-organ damage. The study by 1 provides guidance on the management of hypertension, including the use of amlodipine in specific scenarios. Key points to consider in the management of hypertensive urgency include:
- The initial assessment of the patient to determine the severity of the hypertension and the presence of any end-organ damage
- The selection of an appropriate antihypertensive agent, taking into account the patient's medical history and potential contraindications
- The monitoring of the patient's blood pressure and adjustment of the treatment plan as needed In the context of hypertensive urgency, the use of amlodipine at a dose of 5 mg daily is recommended as an initial treatment option, with the understanding that more rapid-acting agents may be necessary in certain situations. It is also important to note that amlodipine may not be the most suitable option for all patients, particularly those with certain comorbidities or those who require more rapid blood pressure reduction. However, based on the available evidence, initiating amlodipine at a dose of 5 mg daily is a reasonable approach for the treatment of hypertensive urgency in select patients, as supported by the study 1.
From the FDA Drug Label
The usual initial antihypertensive oral dose of Amlodipine besylate tablets is 5 mg once daily The initial dosage of Amlodipine for hypertensive urgency is not explicitly stated in the label, but for hypertension in general, the initial dose is 5 mg once daily.
- The label does not provide specific guidance for hypertensive urgency.
- The provided information is for hypertension in adults, with a usual initial dose of 5 mg once daily 2
From the Research
Initial Dosage of Amlodipine for Hypertensive Urgency
- The initial dosage of Amlodipine for hypertensive urgency is not explicitly stated in the provided studies as "hypertensive urgency" is not mentioned.
- However, the studies suggest that the starting dose of Amlodipine for hypertension is 5 mg once daily, with the option to increase to 10 mg if necessary 3, 4, 5, 6, 7.
- The dose-ranging studies have shown that 5 mg once daily is the most appropriate starting dose, with simple adjustment to 10 mg if necessary 3.
- The studies also indicate that Amlodipine is effective in reducing blood pressure and is well tolerated in patients with mild to moderate hypertension 4, 5, 6, 7.
- It is worth noting that the provided studies do not specifically address the treatment of hypertensive urgency, but rather the treatment of mild to moderate hypertension.
Dose Titration
- One study suggests that an early increase in dosage of Amlodipine does not provide an advantage in terms of antihypertensive effect, and that a dose increase should not be considered until after six weeks of treatment at 5 mg once daily 4.
- Another study found that the dose of Amlodipine could be increased to 10 mg once daily if diastolic blood pressure was not less than or equal to 90 mmHg after four or eight weeks of treatment 5.