What is the maximum daily dose of Amlodipine (Calcium Channel Blocker)?

From the Guidelines

The maximum recommended dose of amlodipine is 10 mg once daily for most adults. Treatment typically starts at a lower dose of 5 mg once daily, which can be increased gradually based on blood pressure response and tolerability. For elderly patients or those with hepatic impairment, starting at 2.5 mg daily is recommended. Amlodipine is a calcium channel blocker that works by relaxing blood vessels, making it easier for the heart to pump blood and reducing blood pressure. It has a long half-life of 30-50 hours, allowing for once-daily dosing. Side effects may include peripheral edema, headache, flushing, and dizziness. These effects are dose-dependent, so using the lowest effective dose is important. Amlodipine can be taken with or without food, and at any time of day, though taking it at the same time each day helps maintain consistent blood levels. If a dose is missed, it should be taken as soon as remembered, unless it's almost time for the next dose.

Some key points to consider when prescribing amlodipine include:

• Starting dose: 5 mg once daily for most adults
• Maximum dose: 10 mg once daily
• Dose adjustment: based on blood pressure response and tolerability
• Special considerations: elderly patients or those with hepatic impairment should start at 2.5 mg daily
• Side effects: peripheral edema, headache, flushing, and dizziness

According to the evidence from 1, the usual dose range for amlodipine is 2.5-10 mg/d, with a daily frequency of 1. Additionally, 1 provides information on the initial and maximal doses of amlodipine for children, which is 2.5 mg/d and 5 mg/d, respectively. However, the most recent and highest quality study is not explicitly stated, but based on the available evidence, the recommended dose of amlodipine remains 5-10 mg once daily.

It's also important to note that amlodipine has a favorable safety profile, with a low risk of adverse effects, as reported in 1. However, as with any medication, it's essential to monitor patients for potential side effects and adjust the dose accordingly.

In terms of specific patient populations, elderly patients or those with hepatic impairment should be started at a lower dose of 2.5 mg daily, as recommended in the evidence from 1. This is to minimize the risk of adverse effects and ensure safe and effective treatment.

Overall, the recommended dose of amlodipine is 5-10 mg once daily, with adjustments made based on individual patient response and tolerability.

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. Small, fragile, or elderly patients, or patients with hepatic insufficiency may be started on 2. 5 mg once daily and this dose may be used when adding Amlodipine besylate tablets to other antihypertensive therapy. Angina: The recommended dose for chronic stable or vasospastic angina is 5 to 10 mg, with the lower dose suggested in the elderly and in patients with hepatic insufficiency. Most patients will require 10 mg for adequate effect. Coronary artery disease: The recommended dose range for patients with coronary artery disease is 5 to 10 mg once daily. In clinical studies, the majority of patients required 10 mg [see Clinical Studies (14. 4)] . 2.2 Children The effective antihypertensive oral dose in pediatric patients ages 6 to 17 years is 2.5 mg to 5 mg once daily. Doses in excess of 5 mg daily have not been studied in pediatric patients [see Clinical Pharmacology (12.4), Clinical Studies (14.1)] .

The recommended dose of Amlodipine is:

• Initial dose: 5 mg once daily for adults
• Maximum dose: 10 mg once daily for adults
• Alternative initial dose: 2.5 mg once daily for small, fragile, or elderly patients, or patients with hepatic insufficiency
• Pediatric dose: 2.5 mg to 5 mg once daily for patients ages 6 to 17 years 2

From the Research

Amlodipine Dosage

• The recommended starting dose of amlodipine is 5 mg once daily, with the option to adjust to 10 mg if necessary 3, 4.
• Amlodipine can be used in combination with other antihypertensive agents, such as angiotensin converting enzyme inhibitors, beta-blockers, or thiazide diuretics, to produce additional antihypertensive effects 3.
• The dosage of amlodipine may need to be adjusted in certain patient populations, such as the elderly or those with renal impairment 5, 4.
• Amlodipine has been shown to be effective in reducing blood pressure and controlling hypertension in various patient populations, including those with mild to moderate essential hypertension 4, 6.
• The most common side effects of amlodipine include edema, palpitations, dizziness, and flushing, which are more common with the higher dose of 10 mg 5, 7.

Comparison with Other Agents

• Amlodipine has been compared to other antihypertensive agents, such as barnidipine, and has been shown to have similar antihypertensive effects 6.
• Amlodipine has also been compared to other calcium channel blockers, such as verapamil and nitrendipine, and has been shown to have superior or comparable antihypertensive efficacy 3, 7.
• Amlodipine has been shown to be at least as well tolerated as other standard antihypertensive agents, including beta-blockers, diuretics, and ACE inhibitors 3, 7.