Timing of Amlodipine Administration
Take amlodipine at the time most convenient for you to ensure consistent daily adherence—morning or bedtime dosing are equally acceptable, as current high-quality guidelines explicitly state there is no cardiovascular benefit to preferential bedtime dosing. 1
Guideline-Based Recommendations
The most recent evidence from the European Society of Cardiology (2025) establishes that antihypertensive medications, including amlodipine, should be taken at whatever time of day is most convenient for the patient to establish a habitual pattern that improves adherence (Class I, Level B recommendation). 1 This represents a significant shift from earlier recommendations, as subsequent high-quality trials have failed to reproduce the cardiovascular benefits of bedtime dosing found in older studies. 1
Key Principles for Timing
Current guidelines do not recommend preferential bedtime dosing of antihypertensives, as the benefits observed in earlier studies (including a 2014 trial showing reduced cardiovascular events with bedtime dosing in diabetic patients) have not been consistently reproduced in more recent, higher-quality trials. 2, 1
Consistency matters more than specific timing—taking amlodipine at the same time each day is the priority for maintaining therapeutic blood pressure control throughout the 24-hour period. 1, 3
The FDA label for amlodipine states it should be taken once daily, with or without food, and recommends taking it at the same time every day (such as with breakfast, dinner, or at bedtime) to make adherence easier. 3
Clinical Context: When Bedtime Dosing May Be Considered
While guidelines prioritize convenience, there are specific clinical scenarios where bedtime dosing could be discussed:
For patients with documented non-dipper hypertension (lack of normal nocturnal blood pressure decline), some evidence suggests evening amlodipine may better reduce nighttime blood pressure and convert non-dippers to a more normal dipper pattern. 4, 5, 6
In diabetic patients with hypertension, older guidelines (2014) noted that taking at least one antihypertensive at bedtime reduced cardiovascular events in one trial, though this is no longer a strong recommendation in current guidelines. 2, 1
Amlodipine provides 24-hour blood pressure control regardless of dosing time, making it effective when taken either morning or evening. 7, 8
Practical Implementation
Select a time that fits the patient's daily routine (morning with breakfast, evening with dinner, or at bedtime) to maximize the likelihood of consistent adherence. 1, 3
Avoid switching between morning and evening dosing without clinical justification, as consistency is key to maintaining stable blood pressure control. 3
If a dose is missed, take it as soon as remembered, but skip it if more than 12 hours have passed since the scheduled time—do not double dose. 3
Important Caveats
Do not stop taking amlodipine or other blood pressure medications without consulting your physician, even if blood pressure appears controlled. 3
Monitor for side effects including leg/ankle swelling, dizziness, flushing, or extreme fatigue, which can occur regardless of dosing time. 3
In rare cases, starting amlodipine or increasing the dose may worsen angina or trigger a heart attack—seek immediate medical attention if chest pain worsens. 3