Best Time of Day to Take Amlodipine
Take amlodipine at whatever time of day is most convenient for you to establish a consistent daily routine—morning or evening dosing are equally effective for blood pressure control and cardiovascular outcomes. 1
Guideline-Based Recommendations
The European Society of Cardiology explicitly states that current evidence does not support bedtime dosing over morning dosing for improving cardiovascular outcomes (Class I, Level B recommendation). 1 The priority is selecting a time that maximizes adherence rather than mandating a specific hour. 1
Key Principles for Timing
Consistency trumps specific timing: Take amlodipine at the same time each day in a consistent setting to ensure adherence and stable blood pressure control. 1
Patient convenience is paramount: Choose morning or evening based on your daily routine and what you're most likely to remember consistently. 1
No need to switch established regimens: If you're already taking amlodipine successfully at night with good adherence, there is no reason to change to morning dosing. 1, 2
Why Timing Doesn't Matter for Amlodipine
Amlodipine provides true 24-hour blood pressure control with once-daily dosing due to its long half-life and pharmacokinetic properties. 3, 4 This means effective blood levels are maintained throughout the entire dosing interval regardless of when you take it. 4
Supporting Research Evidence
A randomized crossover study demonstrated that both morning (8 AM) and evening (8 PM) administration of amlodipine 5 mg significantly reduced daytime and nighttime blood pressure equally, without disrupting the normal circadian blood pressure pattern. 5
A 2021 randomized trial (NARRAS) in non-dipper hypertensive patients found that nighttime dosing of amlodipine reduced nocturnal systolic blood pressure by 9.9 mmHg, which was identical to daytime dosing (10.9 mmHg reduction), with no statistical difference between timing groups. 6
Common Pitfalls to Avoid
Do not switch patients from morning to evening dosing based on outdated recommendations about bedtime administration—this may disrupt established adherence patterns without any proven benefit. 1, 2 Earlier studies suggesting benefits of bedtime dosing have not been consistently reproduced in subsequent high-quality trials. 1
Avoid taking amlodipine at varying times each day, as inconsistency undermines stable blood pressure control. 1
Practical Implementation
Start with 5 mg once daily at your chosen time (morning or evening), with adjustment to 10 mg if needed after 3-4 weeks. 4
Use 90-day refills instead of 30-day when allowed to reduce barriers to adherence. 3
Consider fixed-dose combinations if you need multiple antihypertensive medications, as single-pill combinations improve adherence. 3, 1
Monitor blood pressure regularly with home blood pressure monitoring to confirm effectiveness regardless of administration time. 1