At what time should amlodipine (calcium channel blocker) 5 mg be repeated if blood pressure (BP) is not controlled with the initial 5 mg dose?

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From the FDA Drug Label

2 DOSAGE & ADMINISTRATION 2.1 Adults The usual initial antihypertensive oral dose of Amlodipine besylate tablets is 5 mg once daily, and the maximum dose is 10 mg once daily. ... In general, wait 7 to 14 days between titration steps.

The FDA drug label does not answer the question.

From the Research

If blood pressure is not controlled with an initial dose of amlodipine 5 mg, the dose can typically be increased to 10 mg after 7-14 days of treatment, as amlodipine reaches steady-state plasma levels after approximately 7-8 days of consistent dosing 1. When increasing the dose, continue taking it once daily, preferably at the same time each day. The maximum recommended daily dose of amlodipine is 10 mg. Key points to consider:

  • Amlodipine is a first-line antihypertensive agent with good efficacy and safety, as well as strong evidence from large randomized controlled trials for cardiovascular event reduction 1.
  • If blood pressure remains uncontrolled even with the 10 mg dose, your healthcare provider may consider adding a second antihypertensive medication from a different class rather than further increasing the amlodipine dose, as this approach is often more effective and has fewer side effects than using higher doses of a single medication 2.
  • During dose adjustments, it's essential to monitor for side effects such as peripheral edema, headache, or dizziness, which may become more pronounced at higher doses.
  • Regular blood pressure monitoring at home can help determine if the medication is effectively controlling your blood pressure. The most recent and highest quality study 2 supports the use of amlodipine as a first-line agent, and the addition of a second antihypertensive medication if necessary, to improve blood pressure control and patient outcomes.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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