Can Amlodipine Be Taken in the Morning?
Yes, amlodipine can be taken in the morning—in fact, current guidelines recommend taking it at whatever time of day is most convenient for you to establish a consistent daily routine. 1
Guideline-Based Timing Recommendations
The European Society of Cardiology explicitly states that antihypertensive medications, including amlodipine, should be taken at the most convenient time for the patient to improve adherence, with no preference for morning versus evening dosing (Class I, Level B recommendation). 1
Current guidelines do not recommend preferential bedtime dosing of antihypertensives, as benefits observed in earlier studies (such as the ADVANCE trial showing reduced cardiovascular events with bedtime dosing in diabetic patients) have not been consistently reproduced in more recent, higher-quality trials. 1, 2
Consistency matters more than specific timing—taking amlodipine at the same time each day is the priority for maintaining therapeutic blood pressure control throughout the 24-hour period. 1
Pharmacologic Rationale for Flexible Timing
Amlodipine's unique pharmacokinetic properties make timing less critical than with other antihypertensives:
The drug has a long elimination half-life of 40-60 hours, which means it accumulates to steady-state over 1-1.5 weeks with once-daily dosing. 3
Plasma drug concentration fluctuation between doses is only 20-25% with once-daily administration, providing stable blood levels throughout the day regardless of when you take it. 3
After reaching steady state, blood pressure is decreased from baseline with little fluctuation over the entire 24-hour dosing interval. 3
The gradual onset of effect (peak plasma concentration occurs 6-8 hours after dosing) means there is no abrupt blood pressure drop that would make timing critical. 3
Practical Administration Guidance
The FDA-approved patient information states: "Take amlodipine tablets once a day, with or without food. It may be easier to take your dose if you do it at the same time every day, such as with breakfast or dinner, or at bedtime." 4
For pediatric patients (ages 6-17 years), amlodipine is dosed once daily (QD) at 2.5-5 mg, with no specific time-of-day recommendation. 2
In elderly patients (≥65 years), one large open-label study of 5,135 patients found that morning dosing appeared to confer a slight advantage over evening dosing, though both were effective and well-tolerated. 5
When Bedtime Dosing May Be Considered
While not a strong current recommendation, there are specific scenarios where bedtime dosing has been studied:
In the ADVANCE trial, diabetic patients with hypertension who took at least one antihypertensive at bedtime showed reduced cardiovascular events, though this is no longer emphasized in current European Society of Cardiology guidelines. 1, 2
For resistant hypertension specifically, the American Heart Association notes that altering dosing times to include a nocturnal dose may improve blood pressure control even with long-acting agents like amlodipine. 1
Dosing Recommendations
The appropriate starting dose is 5 mg once daily, which can be increased to 10 mg daily if needed to control blood pressure or angina symptoms. 6, 7, 8
In elderly patients or those with hepatic impairment, starting at 2.5 mg once daily is appropriate. 2
Amlodipine provides effective anti-anginal and anti-ischemic efficacy for a full 24 hours when dosed once daily, as confirmed by exercise testing performed 24 hours post-dose. 6
Common Pitfalls to Avoid
Do not switch dosing times frequently—pick morning or evening and stick with it to maintain steady therapeutic levels and optimize adherence. 1
Do not assume bedtime dosing is superior—the evidence for chronotherapy with amlodipine is not strong enough to mandate evening administration. 1
If you miss a dose and it has been more than 12 hours, skip that dose and take the next one at your regular scheduled time rather than doubling up. 4