What are the hold parameters for amlodipine?

From the Guidelines

Amlodipine hold parameters are not explicitly stated in the provided evidence, but its dosage and administration are well-established.

Amlodipine Dosage and Administration

• The usual dose of amlodipine is 2.5-10 mg once daily 1.
• Amlodipine is a dihydropyridine calcium channel blocker that can be used to control hypertension and angina 1.
• It is recommended to avoid using amlodipine in patients with heart failure with reduced ejection fraction (HFrEF) unless required, and to use it with caution in patients with severe bilateral renal artery stenosis or those with a history of angioedema with ACE inhibitors or ARBs 1.
• Amlodipine may be used for the treatment of hypertension in patients who have elevated blood pressure despite optimization of guideline-directed medical therapy (GDMT) 1.
• The evidence suggests that amlodipine has a neutral effect on survival in patients with heart failure, making it a safe alternative for the treatment of concomitant arterial hypertension or angina not controlled by nitrates and beta-blockers 1.

Key Considerations

• Monitor patients for dose-related pedal edema, which is more common in women than men 1.
• Avoid using amlodipine in combination with other calcium channel blockers or beta blockers unless necessary, due to the increased risk of hypotension, bradycardia, and heart block 1.
• Amlodipine can be used in patients with chronic kidney disease (CKD), but with caution and close monitoring of serum potassium and creatinine levels 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Hold Parameters for Amlodipine

The hold parameters for amlodipine are not explicitly stated in the provided studies. However, the pharmacokinetic and pharmacodynamic properties of amlodipine can be summarized as follows:

• Amlodipine has a low renal clearance of 7 mL/min/mg 2
• It has a long half-life of 35-50 hours 2, 40-60 hours 3
• The duration of action is more than 24 hours following a single dose 2
• Amlodipine has a high oral bioavailability of 60-80% 3
• The onset of effect is gradual, with peak plasma drug concentration occurring 6-8 hours after dosing 3
• The fluctuation of plasma drug concentration between doses is between 20 and 25% when once-daily dosing is used 3

Key Properties of Amlodipine

Some key properties of amlodipine include:

• Effective for the treatment of hypertension and angina pectoris with once-daily dosing 3
• Reduces blood pressure variability and successfully lowers blood pressure 2
• Maintains blood pressure control even when a dose has been missed 2
• Has a favorable safety profile, with a low incidence of side effects such as headache, flushing, and dizziness 4
• Is well-tolerated when used in combination with other agents, such as beta-blockers, diuretics, ACE inhibitors, and nitrates 4

Clinical Efficacy of Amlodipine

The clinical efficacy of amlodipine has been demonstrated in several studies, including:

• A prospective, multicenter, observational real-world study from India, which found that amlodipine 5/10 mg/day therapy provided significant reductions in both office BP and ambulatory BP over eight weeks 5
• A comparative study on clinical and biochemical parameters in amlodipine and cilnidipine treated hypertensive patients, which found that both drugs were equally effective in reducing blood pressure 6