Amlodipine maximum recommended dosage
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Amlodipine Maximum Recommended Dosage in Hypertension Management
Maximum Dosage and Dose-Response in Hypertension
Clinical studies consistently show that the maximum recommended daily dose of amlodipine for hypertension is 10 mg once daily. This dose has been evaluated in multiple trials, demonstrating significant blood pressure reduction and a favorable safety profile. Doses above 10 mg do not provide additional benefit and are not recommended for routine use in hypertension management 1356.
Efficacy and Safety at Maximum Dose
Amlodipine at 10 mg daily produces a clear, dose-related reduction in both systolic and diastolic blood pressure, with the minimum effective dose being 2.5 mg. The 10 mg dose is well tolerated, with side effects generally mild to moderate and no significant impact on heart rate, electrocardiogram, or body weight . In combination therapies, such as with perindopril or olmesartan, the 10 mg dose of amlodipine is also commonly used and shown to be effective and bioequivalent whether given alone or in fixed-dose combinations 36.
Comparison with Combination Therapies
For patients whose blood pressure is not controlled with amlodipine 5 mg, increasing the dose to 10 mg is a standard approach. However, studies suggest that combining amlodipine 5 mg with another antihypertensive (such as bisoprolol 5 mg) may provide similar or slightly better diastolic blood pressure reduction compared to uptitration to 10 mg amlodipine, with no meaningful difference in systolic blood pressure . This supports the use of combination therapy as an alternative to maximum monotherapy dosing in some patients.
Special Considerations for Dose Adjustment
In certain clinical scenarios, such as drug-drug interactions (e.g., with ritonavir), dose adjustments may be necessary. Modeling studies indicate that after stopping a CYP3A inhibitor like ritonavir, it is generally safe to resume the full 5 mg or 10 mg daily dose of amlodipine, with close clinical monitoring .
Conclusion
The maximum recommended dosage of amlodipine for hypertension is 10 mg once daily. This dose is effective, well tolerated, and widely used in both monotherapy and combination therapy regimens. For some patients, combination therapy with other antihypertensives may be considered as an alternative to increasing amlodipine to its maximum dose. Dose adjustments may be needed in the context of drug interactions, but the 10 mg daily limit remains the standard for most patients 13567.
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