Maximum Dose of Amlodipine
The maximum recommended dose of amlodipine for treating hypertension in adults is 10 mg once daily. 1
Standard Adult Dosing
- The FDA-approved maximum dose is 10 mg once daily for hypertension, angina, and coronary artery disease. 1
- The American College of Cardiology confirms the standard dosing range of 2.5-10 mg once daily for adults. 2
- Initial dosing typically starts at 5 mg once daily, with titration to 10 mg if blood pressure goals are not achieved. 1
- Dose adjustments should generally occur after 7-14 days between titration steps, though more rapid titration is acceptable if clinically warranted with frequent patient assessment. 1
Special Populations
Elderly, Fragile, or Hepatically Impaired Patients
- Start at 2.5 mg once daily in small, fragile, elderly patients, or those with hepatic insufficiency. 1
- This lower starting dose is also appropriate when adding amlodipine to existing antihypertensive therapy. 1
Pediatric Patients (Ages 6-17)
- The maximum dose is 5 mg once daily for children and adolescents. 3, 1
- The American Academy of Pediatrics explicitly states that doses exceeding 5 mg daily are not recommended due to lack of pediatric studies. 3
- Effective dosing range is 2.5-5 mg once daily. 1
- Children under 6 years should not receive amlodipine. 3
Off-Label Higher Dosing (Specific Context Only)
- For idiopathic pulmonary arterial hypertension (IPAH) in vasoreactive patients, doses up to 20 mg daily may be used, though this is off-label. 3
- The European Society of Cardiology reserves this higher dosing only for carefully selected IPAH patients demonstrating positive acute vasodilator response during right heart catheterization. 3
- When coadministered with simvastatin or lovastatin, the American Heart Association advises amlodipine doses should not exceed 20 mg daily due to increased statin exposure and myopathy risk. 3
Clinical Efficacy Data
- Research demonstrates that 73% of patients achieve target blood pressure with 10 mg once daily, compared to 56% with 5 mg. 4
- The long half-life (30-50 hours) supports true once-daily dosing with sustained 24-hour blood pressure control. 2, 3
- Most patients with coronary artery disease or angina require the full 10 mg dose for adequate therapeutic effect. 1
Common Pitfall to Avoid
Do not increase the dose before 6 weeks of treatment at 5 mg once daily unless clinically urgent. Research shows no advantage to early dose escalation, as blood pressure continues to decrease steadily through the first 6 weeks of therapy. 5