When is the best time of day to take amlodipine?

Optimal Timing for Amlodipine Administration

Take amlodipine at whatever time of day is most convenient for you to establish a consistent daily routine—morning or evening dosing produces equivalent blood pressure control and cardiovascular outcomes. 1, 2

Guideline-Based Recommendation

The European Society of Cardiology provides a Class I, Level B recommendation that antihypertensive medications, including amlodipine, should be taken at the time of day that best fits your routine to maximize adherence, rather than at a specific time for pharmacological reasons. 1, 2 Current guidelines explicitly recommend against preferential bedtime dosing, as the cardiovascular benefits observed in earlier studies have not been consistently reproduced in more recent, higher-quality trials. 1, 2

Why Timing Flexibility Works for Amlodipine

Amlodipine's pharmacokinetic profile supports flexible dosing:

• The medication has an exceptionally long half-life of 30-50 hours, which maintains therapeutic blood levels throughout the entire 24-hour period regardless of when you take it. 3
• This long duration of action is specifically why amlodipine is designed and approved for once-daily administration. 3
• The FDA label confirms that amlodipine 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 establish a habit. 4

Practical Implementation Strategy

Choose your dosing time based on these adherence factors:

• Select a time linked to an existing daily habit (morning coffee, dinner, brushing teeth at bedtime) to minimize missed doses. 4
• Consistent medication-taking is the strongest predictor of blood pressure control and cardiovascular risk reduction, outweighing any modest effects of specific dosing times. 1
• If you miss a dose, take it as soon as you remember—but if more than 12 hours have passed, skip that dose and resume at your regular time. 4

Special Consideration: Non-Dipper Hypertension

For patients with non-dipper hypertension (those who don't experience normal nighttime blood pressure drops), evening dosing may offer additional benefit:

• A 2019 meta-analysis of 19 trials found that evening amlodipine administration significantly reduced nighttime blood pressure (mean difference 2.04 mmHg) and improved non-dipper conversion rates compared to morning dosing. 5
• However, this finding has not been incorporated into major guideline recommendations, and the European Society of Cardiology review concluded that timing does not influence major cardiovascular outcomes such as myocardial infarction, stroke, or cardiovascular death. 1

Research Evidence Shows Conflicting Results

The research literature presents contradictory findings on timing:

• One 2003 study found morning dosing produced better 24-hour diastolic blood pressure control and greater nocturnal blood pressure fall compared to evening dosing. 6
• Conversely, a 1998 study showed both morning and evening administration equally reduced daytime blood pressure, with no clinically significant difference in circadian patterns. 7
• A 1997 study demonstrated that amlodipine appropriately reduces blood pressure in non-dippers and mild dippers without causing excessive nocturnal drops in extreme dippers, regardless of dosing time. 8

These conflicting results reinforce the guideline position that adherence matters more than timing.

Common Pitfall to Avoid

Do not switch your dosing time frequently in an attempt to optimize blood pressure control—this disrupts adherence and is the primary cause of treatment failure. 1 If blood pressure targets (120-129/70-79 mmHg) are not achieved within 3 months, your clinician should intensify or modify your medication regimen rather than alter dosing time. 1

Bottom Line Algorithm

1. Choose morning OR evening based solely on which time you can reliably remember every single day. 1, 2, 4
2. If you take thiazide diuretics concurrently, morning dosing of the diuretic is generally preferred to minimize nighttime urination, but this doesn't dictate amlodipine timing. 1
3. If you have documented non-dipper hypertension on ambulatory monitoring, discuss evening dosing with your physician as a potential optimization strategy. 5
4. Stick with your chosen time consistently—changing timing does not improve outcomes and worsens adherence. 1