Maximum Dose of Cilnidipine
The maximum recommended daily dose of cilnidipine in adults is 20 mg once daily.
Dosing Guidelines
Standard dosing for cilnidipine begins at 10 mg once daily and can be increased to a maximum of 20 mg once daily based on blood pressure response 1, 2, 3. This dosing range has been consistently validated across multiple clinical studies examining cilnidipine's efficacy in hypertensive patients.
Key Dosing Parameters
- Starting dose: 10 mg once daily 1, 2, 3
- Maximum dose: 20 mg once daily 1, 2, 3
- Titration: Increase from 10 mg to 20 mg based on blood pressure control 1, 2, 3
Administration Timing
Cilnidipine can be administered either in the morning or at bedtime with equivalent efficacy, though bedtime dosing may provide superior control of morning hypertension 4, 2. The drug maintains 24-hour blood pressure control regardless of administration time 4.
- Morning dosing effectively reduces 24-hour, daytime, and nighttime blood pressure 4
- Bedtime administration specifically targets morning hypertension and reduces the morning blood pressure surge 2
- Both timing regimens suppress early morning blood pressure elevation 4
Clinical Advantages at Recommended Doses
Cilnidipine at 10-20 mg daily provides blood pressure reduction without reflex tachycardia, distinguishing it from other dihydropyridine calcium channel blockers 5, 4. This unique profile results from its dual L-type and N-type calcium channel blocking action 5.
- Heart rate remains stable or decreases slightly compared to other calcium channel blockers 5
- Sympathetic nervous system activity is not increased 4
- Morning sympathetic activation is partially inhibited 4
Important Clinical Considerations
Do not exceed 20 mg daily as this represents the maximum studied and recommended dose in clinical trials 1, 2, 3. Higher doses have not been evaluated for safety or efficacy.
Monitor for additional benefits beyond blood pressure control at therapeutic doses, including: