Can I double the dose of amlodipine besylate 5 mg and valerian 80 mg, given my blood pressure of 163/57 mm Hg and pulse of 57 bpm measured 24 hours after taking them?

Do Not Double Your Medications

You should NOT double either medication on your own—your blood pressure of 163/57 mmHg requires medical evaluation before any dose adjustment, and valerian is not a standard antihypertensive agent that should be self-adjusted. Your pulse of 57 bpm is at the lower end of normal, and your diastolic pressure of 57 mmHg is concerning for excessive lowering.

Why This Matters

Your systolic blood pressure (163 mmHg) remains elevated and uncontrolled, but your diastolic pressure (57 mmHg) is already quite low. This creates a complex situation:

• The 2024 ESC Guidelines recommend targeting systolic BP of 120-129 mmHg 1, so your systolic pressure of 163 mmHg clearly needs better control
• However, your diastolic of 57 mmHg is already below the recommended target range of 70-79 mmHg for most adults 1
• Your pulse of 57 bpm, while technically normal, is on the lower end and could drop further with medication increases

The Amlodipine Question

According to FDA labeling, amlodipine can be increased from 5 mg to 10 mg for hypertension 22, but this decision requires medical supervision because:

• The FDA recommends waiting 7 to 14 days between dose titrations and assessing the patient frequently 2
• You've only waited 24 hours, which is insufficient time to assess the full effect of your current dose
• Amlodipine has a long half-life of 35-50 hours 3, meaning it takes several days to reach steady-state blood pressure control
• Doubling the dose increases risk of side effects including excessive blood pressure lowering, edema, dizziness, and palpitations 2

The Valerian Problem

Valerian is an herbal supplement, not a proven antihypertensive medication. The evidence-based guidelines recommend ACE inhibitors, ARBs, calcium channel blockers (like amlodipine), and diuretics as first-line treatments 11. Valerian is not among these. Doubling an unproven supplement while your blood pressure remains uncontrolled is not evidence-based management.

What You Should Do Instead

Contact your physician within 24-48 hours to discuss:

1. Adding a second evidence-based antihypertensive rather than doubling amlodipine alone—the 2024 ESC Guidelines recommend combination therapy for most patients with BP ≥140/90 mmHg 11
2. The preferred combination would be amlodipine plus either an ACE inhibitor, ARB, or thiazide diuretic 14
3. Your low diastolic pressure (57 mmHg) needs evaluation—this wide pulse pressure may indicate arterial stiffness or other issues requiring specific management
4. Discontinuing valerian and replacing it with an evidence-based medication

Critical Safety Points

• Never self-adjust blood pressure medications without medical guidance—the risk of excessive lowering (especially your already-low diastolic) or rebound hypertension is real
• Your current regimen is inadequate monotherapy for BP ≥140/90 mmHg 1
• The combination approach has been shown to achieve BP control rates of 71-74% versus lower rates with monotherapy 56
• Missing doses or erratic dosing increases cardiovascular risk

Bottom line: Schedule an urgent appointment with your doctor rather than self-adjusting doses. Your blood pressure pattern suggests you need combination therapy with evidence-based medications, not dose doubling of your current regimen.