How quickly does amlodipine work
Pro Research Analysisby 
Searched over 200M research papers
How Quickly Does Amlodipine Work?
Onset of Action: Initial Effects
Amlodipine, a long-acting calcium channel blocker, is known for its gradual onset of action. After oral administration, the drug begins to take effect within a few hours. Peak plasma concentrations are typically reached between 6 to 8 hours post-dose, which aligns with the gradual onset of its therapeutic effects 57. This slow absorption rate contributes to a steady and sustained release of the medication into the bloodstream, ensuring prolonged efficacy.
Efficacy in Angina Pectoris
In patients with chronic stable angina, amlodipine has demonstrated significant improvements in exercise tolerance and a reduction in angina attack frequency within the first few weeks of treatment. A study involving 103 patients showed that amlodipine significantly increased exercise duration and decreased the frequency of angina attacks and nitroglycerin consumption after just 4 weeks of treatment 1. Another study confirmed these findings, noting improvements in exercise parameters as early as 6 hours after dosing, with sustained effects observed at 24 hours 2.
Blood Pressure Control
Amlodipine is also effective in managing hypertension, with significant reductions in blood pressure observed within the first two weeks of treatment. In a study of hypertensive patients, mean supine blood pressure decreased notably after 2 weeks of treatment with amlodipine, and further reductions were seen after 6 weeks 38. Continuous 24-hour blood pressure monitoring revealed that amlodipine effectively maintained blood pressure control throughout the day and night without altering the normal circadian pattern 8.
Pharmacokinetics and Steady-State Achievement
The pharmacokinetic profile of amlodipine supports its once-daily dosing regimen. The drug has a long elimination half-life of 40 to 60 hours, allowing it to accumulate to steady-state levels within 7 to 10 days of daily administration 56. This steady-state is characterized by minimal fluctuations in plasma drug concentrations, ensuring consistent therapeutic effects over the 24-hour dosing interval 7.
Anti-Ischemic Effects
Amlodipine's efficacy extends to reducing myocardial ischemia in patients with coronary artery disease. The CAPE trial demonstrated that amlodipine significantly reduced both symptomatic and asymptomatic ischemic events over a 24-hour period, with a notable reduction in the frequency and total area of ST-segment depressions 4. These effects were observed after 7 weeks of treatment, indicating a rapid onset of anti-ischemic benefits.
Conclusion
Amlodipine begins to work within a few hours of oral administration, with peak effects typically observed between 6 to 8 hours. Significant therapeutic benefits in terms of angina relief and blood pressure reduction can be seen within the first few weeks of treatment. The drug's long half-life and steady-state pharmacokinetics support its efficacy in once-daily dosing, providing consistent and sustained therapeutic effects.
Sources and full results
Most relevant research papers on this topic
Amlodipine in chronic stable angina: results of a multicenter double-blind crossover trial.
Amlodipine effectively increases exercise duration and reduces angina attacks, while maintaining symptom control in chronic stable angina patients.
RCTA four-week double-blind, placebo-controlled, parallel dose-response study of amlodipine in patients with stable exertional angina pectoris.
Amlodipine is an effective and well-tolerated once-daily treatment for chronic stable angina, with no severe adverse reactions compared to placebo.
RCT24 h blood pressure control with the once daily calcium antagonist, amlodipine.
Amlodipine effectively reduces blood pressure in hypertensive patients over a 24-hour period, with a once-daily dose regimen providing steady state blood levels.
RCTAmlodipine reduces transient myocardial ischemia in patients with coronary artery disease: double-blind Circadian Anti-Ischemia Program in Europe (CAPE Trial).
Once-daily amlodipine significantly reduces both symptomatic and asymptomatic ischemic events over 24 hours in patients with chronic stable angina.
RCT
Large Human Trial
Highly CitedPharmacokinetics and pharmacodynamics of amlodipine.
Amlodipine effectively treats hypertension and angina pectoris with once-daily dosing, offering a low-clearance, dihydropyridine calcium antagonist with high oral bioavailability.
Highly CitedThe pharmacokinetics of amlodipine in healthy volunteers after single intravenous and oral doses and after 14 repeated oral doses given once daily.
Amlodipine has a 36-hour half-life after intravenous administration and a 45-hour half-life after repeated oral administration, with steady state plasma concentration achieved after seven doses.
Non-RCTHighly CitedClinical Pharmacokinetics of Amlodipine
Amlodipine has distinct pharmacokinetic characteristics, making it suitable for single daily administration with minimal drug interactions.
Highly Cited24-hour blood pressure control with the once-daily calcium antagonist amlodipine.
Amlodipine effectively reduces blood pressure for 24 hours after once-daily dosing and is well tolerated in patients with mild to moderate hypertension.
RCTFixed-combination of amlodipine and diuretic chronotherapy in the treatment of essential hypertension: improved blood pressure control with bedtime dosing—a multicenter, open-label randomized study
Amlodipine complexes, when administered at bedtime, can optimize blood pressure control by enhancing lowering effects, increasing diurnal/nocturnal ratio, normalizing blood pressure pattern, and minimizing morning surges.
RCTPharmacodynamics of amlodipine: hemodynamic effects and antianginal efficacy after atrial pacing.
Amlodipine, when administered intravenously, increases the angina threshold without causing negative inotropic effects.
RCT