Amlodipine Does Not Require Tapering When Discontinuing
Amlodipine can be stopped abruptly without tapering due to its unique pharmacokinetic properties that prevent rebound hypertension. 1
Pharmacokinetic Rationale for No Tapering
Amlodipine has distinctive pharmacological characteristics that eliminate the need for gradual dose reduction:
- The elimination half-life is 40-60 hours, which means the drug naturally tapers itself over 7-10 days after discontinuation 1
- Discontinuation results in a slow return of blood pressure to baseline over 7-10 days with no evidence of rebound effect 1
- The drug does not accumulate dangerously and shows no tendency for problematic withdrawal effects even in patients with renal dysfunction 2
Contrast with Medications That Require Tapering
This stands in stark contrast to medications that must be tapered:
- Beta-blockers (atenolol, metoprolol, carvedilol, propranolol) require gradual tapering to avoid rebound hypertension, tachycardia, and potential cardiovascular events 3
- Clonidine must be tapered to avoid rebound hypertension and potential hypertensive crisis 3
- Abrupt cessation of centrally-acting agents can induce dangerous rebound effects 3
Clinical Implementation
When stopping amlodipine:
- Simply discontinue the medication without dose reduction 1
- Monitor blood pressure over the subsequent 7-10 days as it gradually returns to baseline 1
- No special precautions are needed beyond standard blood pressure monitoring 1
- The gradual offset of effect occurs automatically due to the drug's long half-life and slow elimination 1
Important Caveat
If amlodipine is being used in combination with a beta-blocker (such as in fixed-dose combinations with atenolol), the beta-blocker component requires tapering even though amlodipine does not 3, 4. In such cases, separate the medications and taper only the beta-blocker while stopping amlodipine abruptly.