Amlodipine Dosage for Hypertension
Amlodipine 10 micrograms (mcg) is not an effective dosage for treating hypertension; the standard effective dosage range is 2.5-10 milligrams (mg) daily. 1
Correct Dosage Information
- The standard dosage range for amlodipine in treating hypertension is 2.5-10 mg daily, not micrograms 1
- Amlodipine is typically administered once daily due to its long elimination half-life of 40-60 hours 2
- The minimum effective dose for hypertension is 2.5 mg daily 3
- The recommended initial dose for most patients is 5 mg daily, which can be titrated up to 10 mg if needed 4
Dosing Considerations
- For elderly patients, a lower starting dose may be appropriate as they tend to have decreased clearance and prolonged elimination half-life (64±20 vs. 48±8 hours in younger patients) 5
- When initiating treatment, blood pressure typically decreases gradually over 4-8 hours after dosing, with little fluctuation over the 24-hour dose interval during chronic therapy 2
- Dose titration should not be considered until after six weeks of treatment at 5 mg daily, as early dose increases have not shown advantages in antihypertensive effect 6
Role in Hypertension Management
- Amlodipine is a dihydropyridine calcium channel blocker (CCB) recommended as a first-line agent for hypertension management 4
- CCBs like amlodipine are particularly effective in black adults with hypertension, with or without diabetes 1
- Amlodipine has demonstrated effectiveness in reducing systolic blood pressure by a mean of 17.5 mmHg from baseline, with greater effects observed in elderly patients and those with isolated systolic hypertension 7
Use in Combination Therapy
- For most adults with hypertension, two or more antihypertensive medications are recommended to achieve a BP target of less than 130/80 mm Hg 1
- Amlodipine is often included as part of a multi-drug regimen for resistant hypertension 4
- Fixed-dose combinations containing amlodipine with ACE inhibitors (such as amlodipine-benazepril) are available and can improve adherence 1
Practical Considerations
- Limiting factors for dose increase are usually systemic hypotension and lower limb peripheral edema 1
- Amlodipine has high oral bioavailability (60-80%) and reaches steady-state with once-daily administration over a period of 1-1.5 weeks 2
- Discontinuation of amlodipine results in a slow return of blood pressure to baseline over 7-10 days, with no evidence of a 'rebound' effect 2
Common Pitfalls
- Confusing milligrams (mg) with micrograms (mcg) - the correct dosage unit for amlodipine is milligrams 1
- Starting with too high a dose in elderly patients, who may be more sensitive to the blood pressure-lowering effects 5
- Titrating the dose too early - changes in dosage should be considered after at least 6 weeks of therapy 6
- Not accounting for the gradual onset of action - full therapeutic effect may take 1-1.5 weeks to develop 2