Amlodipine maximum dose

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Maximum Dose of Amlodipine: Insights from Research

Introduction to Amlodipine and Its Usage in Hypertension

Amlodipine is a widely used calcium channel blocker prescribed for the treatment of hypertension and angina. It is known for its efficacy in reducing blood pressure and its relatively favorable side effect profile. Understanding the maximum dose of amlodipine is crucial for optimizing therapeutic outcomes while minimizing adverse effects.

Maximum Dose of Amlodipine in Hypertension Treatment

Clinical Trials and Dose-Response Relationship

Several clinical trials have investigated the dose-response relationship of amlodipine in patients with hypertension. A multicenter, placebo-controlled trial assessed the antihypertensive efficacy and safety of different doses of amlodipine, ranging from 1.25 mg to 10 mg daily. The study found that doses of 5.0-10.0 mg daily were effective in significantly reducing both supine and standing blood pressures after 8 weeks of treatment . Another study confirmed that the maximum dose of amlodipine for effective blood pressure control is 10 mg daily, with a dose-related reduction in blood pressure observed 16.

Comparison with Combination Therapies

In patients whose hypertension is not adequately controlled with amlodipine 5 mg, up-titration to the maximum dose of 10 mg daily has been compared with combination therapies. A study comparing the efficacy of amlodipine 10 mg with a low-dose combination of amlodipine 5 mg and bisoprolol 5 mg found that while both strategies were effective, the combination therapy resulted in a slightly greater reduction in diastolic blood pressure . This suggests that while 10 mg is the maximum monotherapy dose, combination therapies might offer additional benefits in certain patient populations.

Pharmacokinetics in Different Populations

The pharmacokinetics of amlodipine have been studied in both elderly and young hypertensive patients. It was observed that elderly patients (65-73 years) had a prolonged elimination half-life and a greater reduction in systolic blood pressure compared to younger patients (28-34 years) when treated with doses up to 10 mg daily . This indicates that while the maximum dose remains 10 mg, elderly patients may experience more pronounced effects and may require careful monitoring.

Tolerability and Side Effects at Maximum Dose

Amlodipine is generally well-tolerated, but higher doses can be associated with side effects. Common side effects include headache and ankle edema, with the latter being more frequently observed at the 10 mg dose 16. Despite these side effects, the overall tolerability of amlodipine remains favorable, making it a viable option for long-term hypertension management.

Conclusion

The maximum recommended dose of amlodipine for the treatment of hypertension is 10 mg daily. This dosage has been shown to be effective in significantly reducing blood pressure in various patient populations. While combination therapies may offer additional benefits, especially in patients with suboptimal control on lower doses, the 10 mg dose remains the upper limit for monotherapy. Careful consideration of patient-specific factors, such as age and comorbidities, is essential to optimize treatment outcomes and minimize adverse effects.

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Most relevant research papers on this topic

Once daily amlodipine in the treatment of mild to moderate hypertension.

Once-daily amlodipine effectively reduces blood pressure in patients with mild to moderate hypertension, with no significant effects on heart rate or heart rate variability.

RCT

1987·

44citations

·J. Webster et al.

An anchored simulated treatment comparison of uptitration of amlodipine compared with a low-dose combination treatment with amlodipine 5 mg/bisoprolol 5 mg for patients with hypertension suboptimally controlled by amlodipine 5 mg monotherapy

The low-dose combination of amlodipine 5 mg and bisoprolol 5 mg effectively reduces diastolic blood pressure in hypertensive patients, while no significant difference is seen in systolic blood pressure.

2022·

2citations

·C. Foch et al.

Amlodipine in elderly hypertensive patients: pharmacokinetics and pharmacodynamics.

Amlodipine effectively lowers systolic blood pressure in elderly hypertensive patients, with similar results to young patients, but clearance is decreased and elimination half-life is prolonged.

Non-RCT

1988·

45citations

·Darrell R. Abernethy et al.

Comparisons of the pharmacokinetics and tolerability of fixed-dose combinations of amlodipine besylate/losartan and amlodipine camsylate/losartan in healthy subjects: a randomized, open-label, single-dose, two-period, two-sequence crossover study

An FDC of 6.94 mg amlodipine besylate/5 mg losartan potassium is similar to an FDC of 5 mg amlodipine camsylate/5 mg losartan potassium in pharmacokinetics and tolerability in healthy male subjects.

RCTRigorous Journal

2016·

11citations

·Yoonjung Choi et al.

Amlodipine: a double-blind evaluation of the dose-response relationship in mild to moderate hypertension.

Amlodipine effectively reduces blood pressures with once-daily dosing, with 2.5 mg being the minimum effective dose, and is well-tolerated in patients with mild to moderate hypertension.

RCT

1988·

25citations

·Frick Mh et al.

Amlodipine Pharmacokinetics in Healthy Volunteers

Amlodipine effectively lowers blood pressure when given once daily, with headache being the most common side effect, and its long half-life and gradual absorption minimize side effects.

RCT

1988·

61citations

·Dennis M. Williams et al.

Pharmacokinetics of Amlodipine and Olmesartan After Administration of Amlodipine Besylate and Olmesartan Medoxomil in Separate Dosage Forms and as a Fixed‐Dose Combination

The fixed-dose combination of amlodipine and olmesartan is bioequivalent to amlodipine 10 mg plus olmesartan medoxomil 40 mg, with dose-proportional total exposure.

RCT

2008·

32citations

·S. Rohatagi et al.

A double-blind, placebo-controlled, parallel dose-response study of amlodipine in stable exertional angina pectoris.

Amlodipine improves exercise tolerance, reduces angina attacks, and reduces nitroglycerin consumption in patients with stable exertional angina pectoris.

RCT

1991·

12citations

·Stanley H. Taylor et al.

Pharmacokinetic comparison of a fixed-dose combination versus concomitant administration of amlodipine, olmesartan, and rosuvastatin in healthy adult subjects

The fixed-dose combination and co-administration of amlodipine, olmesartan, and rosuvastatin are pharmacokinetically bioequivalent and have similar safety profiles in healthy adult subjects.

RCTRigorous Journal

2019·

8citations

·M. Oh et al.

Comparison of Pharmacokinetics of a Fixed-Dose Combination of Amlodipine/Losartan/Rosuvastatin with Concomitant Administration of Amlodipine/Losartan and Rosuvastatin in Healthy Volunteers

The fixed-dose combination of amlodipine/losartan/rosuvastatin 5/100/20 mg is a pharmacokinetically equivalent replacement for concomitant administration, potentially improving medication compliance in patients with hypertension and dyslipidemia.

RCTRigorous Journal

2020·

2citations

·D. Y. Yoon et al.

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