What is the maximum recommended dose of amlodipine for adult patients?

Maximum Dose of Amlodipine

The maximum recommended dose of amlodipine is 10 mg once daily for adults, as specified by the FDA label and supported by all major cardiology guidelines. 1

Standard Adult Dosing

• The FDA-approved dosing for amlodipine begins at 5 mg once daily as the usual initial antihypertensive dose, with a maximum of 10 mg once daily 1
• For small, fragile, or elderly patients, or those with hepatic insufficiency, the starting dose should be reduced to 2.5 mg once daily 1
• The American College of Cardiology confirms the standard adult dosing range of 2.5-10 mg once daily, with 5-10 mg being the typical therapeutic range 2

Titration Strategy

• When adjusting the dose, wait 7 to 14 days between titration steps under normal circumstances 1
• More rapid titration is acceptable if clinically warranted, provided the patient is assessed frequently 1
• Clinical trial data demonstrates that dose increases from 5 mg to 10 mg should not be considered until after 6 weeks of treatment, as there is no advantage to early dose escalation in terms of antihypertensive effect 3

Indication-Specific Dosing

• For hypertension: The maximum dose is 10 mg once daily 1
• For chronic stable or vasospastic angina: The recommended dose range is 5-10 mg once daily, with most patients requiring 10 mg for adequate symptom control 1, 4
• For coronary artery disease: The recommended dose range is 5-10 mg once daily, with the majority of patients in clinical studies requiring 10 mg 1

Pediatric Maximum Dose

• In pediatric patients ages 6-17 years, the maximum dose is 5 mg once daily 1
• Doses exceeding 5 mg daily have not been studied in pediatric patients and should not be used 1

Pharmacokinetic Rationale

• Amlodipine's long elimination half-life of approximately 30-50 hours (up to 64 hours in elderly patients) supports once-daily dosing and maintains effective blood levels throughout the 24-hour dosing interval 2, 5
• The gradual absorption after oral administration produces gradual vasodilation, reducing reflex tachycardia and headache compared to other calcium antagonists 4

Common Pitfall to Avoid

• Never exceed 10 mg once daily in adults, as this is the FDA-approved maximum dose with no additional efficacy data supporting higher doses 1
• Do not use doses above 5 mg daily in pediatric patients, as safety and efficacy have not been established 1