Maximum Amlodipine Dosage
The maximum recommended dosage of amlodipine is 10 mg once daily for adults and 5 mg once daily for pediatric patients aged 6-17 years. 1
Adult Dosing
- Standard maximum dose: 10 mg once daily 1
- The usual initial dose is 5 mg once daily, which can be titrated to the maximum of 10 mg once daily based on blood pressure response 1
- For small, fragile, or elderly patients, or those with hepatic insufficiency, initiation at 2.5 mg once daily is appropriate, with subsequent titration as needed 1
- Titration intervals should generally be 7-14 days between dose adjustments, though more rapid titration is acceptable if clinically warranted with frequent patient assessment 1
Pediatric Dosing
- Maximum dose in children aged 6-17 years: 5 mg once daily 1, 2
- The effective antihypertensive dose range is 2.5-5 mg once daily 1
- Doses exceeding 5 mg daily have not been studied in pediatric patients and are not recommended 1, 2
- Children under 6 years of age should not receive amlodipine 2
Special Clinical Contexts
Pulmonary Hypertension
- For idiopathic pulmonary arterial hypertension (IPAH) in vasoreactive patients, doses up to 20 mg daily have been used, though this represents an off-label indication 2
- This higher dosing is reserved only for carefully selected IPAH patients who demonstrate positive acute vasodilator response during right heart catheterization 2
Drug Interactions with Statins
- When coadministered with simvastatin or lovastatin, amlodipine doses should not exceed 20 mg daily due to moderate increases in statin exposure and increased risk of myopathy 2
- This represents an important safety consideration, as the combination can increase statin-related adverse effects 2
Important Caveats
- The long half-life of amlodipine (30-50 hours) supports true once-daily dosing and allows for sustained blood pressure control throughout the 24-hour period 3, 4
- Most patients with hypertension achieve adequate control at 5-10 mg daily, with the majority requiring 10 mg for optimal effect 1, 5
- For chronic stable angina or coronary artery disease, most patients require the full 10 mg dose for adequate symptom control 1, 6