From the Guidelines
The maximum daily dose of Norvasc (amlodipine) is 10 mg per 24 hours. This calcium channel blocker medication is typically started at lower doses, such as 2.5 or 5 mg once daily, and can be titrated up to the maximum dose if needed for blood pressure control or angina management 1. Elderly patients or those with hepatic impairment may require lower dosing, often starting at 2.5 mg daily. Norvasc has a long half-life of 30-50 hours, which allows for once-daily dosing, and it should be taken at approximately the same time each day to maintain consistent blood levels. The medication works by relaxing and widening blood vessels, reducing the workload on the heart and improving blood flow. Some key points to consider when prescribing Norvasc include:
- Starting with a low dose and titrating up as needed to minimize side effects
- Monitoring blood pressure and adjusting the dose accordingly
- Being aware of potential side effects, such as peripheral edema, headache, and dizziness
- Not exceeding the maximum daily dose of 10 mg per 24 hours, as higher amounts do not provide additional therapeutic benefit but may increase the risk of adverse effects 1. It's also important to note that the evidence for the use of calcium channel blockers, including Norvasc, is predominantly limited to symptom control in patients with unstable angina or non-ST-elevation myocardial infarction 1. However, in the context of real-life clinical medicine, the primary concern is minimizing morbidity, mortality, and improving quality of life, and the maximum daily dose of 10 mg per 24 hours is recommended to achieve this goal.
From the FDA Drug Label
2 DOSAGE & ADMINISTRATION 2.1 Adults The usual initial antihypertensive oral dose of Amlodipine besylate tablets is 5 mg once daily, and the maximum dose is 10 mg once daily.
The maximum dose of Norvasc (Amlodipine) for a 24-hour period is 10 mg once daily 2.
- The dose can be adjusted according to blood pressure goals.
- The maximum dose is the same for angina and coronary artery disease, which is 10 mg once daily.
From the Research
Norvasc 24 hrs Maximum Dose
The maximum dose of Norvasc (amlodipine) is not explicitly stated in the provided studies. However, the following information can be gathered:
- Amlodipine is a dihydropyridine calcium antagonist, and its use can lead to peripheral edema, a common side effect of antihypertensive therapy with vasodilators 3.
- The incidence of edema is dose-dependent, and treatment with low/medium doses (2.5-5 mg) of amlodipine resulted in lower rates of edema compared to high doses (10 mg) 4.
- The combination of a dihydropyridine calcium antagonist, such as amlodipine, with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) can reduce the risk of peripheral edema 3, 5, 6.
- Amlodipine plus ACE inhibitors reduced peripheral edema the most, with a ranking of 16% in a network meta-analysis 5.
Key Points
- The maximum dose of Norvasc (amlodipine) is not explicitly stated in the provided studies.
- Low/medium doses (2.5-5 mg) of amlodipine are associated with lower rates of edema compared to high doses (10 mg) 4.
- Combination therapy with ACE inhibitors or ARBs can reduce the risk of peripheral edema 3, 5, 6.
Dose-Dependent Effects
- Amlodipine (5 mg) increased leg weight without modifying postural vasoconstriction, indicating that extravascular fluid shift was independent of postural skin vasoconstriction 6.
- At 10 mg, amlodipine blunted postural vasoconstriction and increased leg weight further, suggesting that skin blood flow autoregulation limited additional fluid transfer 6.