Amlodipine Dosage

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Usual Adult Dose for:

Usual Geriatric Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Hypertension

Initial dose: 5 mg orally once a day
Maintenance dose: 5 to 10 mg orally once a day

Small or fragile patients may be started on 2.5 mg orally once a day.

Usual Adult Dose for Angina Pectoris

Chronic stable or vasospastic angina, or angiographically documented coronary artery disease in patients without heart failure or an ejection fraction less than 40%: 5 to 10 mg orally once a day

Most patients with chronic stable or vasospastic angina require 10 mg for adequate effect. In clinical studies, most patients with coronary artery disease required 10 mg.

Usual Adult Dose for Coronary Artery Disease

Chronic stable or vasospastic angina, or angiographically documented coronary artery disease in patients without heart failure or an ejection fraction less than 40%: 5 to 10 mg orally once a day

Most patients with chronic stable or vasospastic angina require 10 mg for adequate effect. In clinical studies, most patients with coronary artery disease required 10 mg.

Usual Geriatric Dose for Hypertension

Initial dose: 2.5 mg orally once a day
Maintenance dose: 2.5 to 10 mg orally once a day

Usual Geriatric Dose for Angina Pectoris

Chronic stable or vasospastic angina: 5 to 10 mg orally once a day
The lower dose is recommended in the elderly; however, most patients require 10 mg for adequate effect.

Usual Pediatric Dose for Hypertension

6 to 17 years: 2.5 mg to 5 mg orally once a day
Doses in excess of 5 mg daily have not been studied in pediatric patients.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Hypertension: Patients with hepatic insufficiency may be started on 2.5 mg orally once a day.

Chronic stable or vasospastic angina: 5 to 10 mg orally once a day
The lower dose is recommended in patients with hepatic insufficiency; however, most patients require 10 mg for adequate effect.

Slow titration is recommended when administering amlodipine to patients with severe hepatic dysfunction.

Dose Adjustments

Dosage should be adjusted according to patient response. In general, titration should proceed over 7 to 14 days. If clinically warranted, titration may proceed more rapidly, provided the patient is assessed frequently.

Precautions

Worsening angina and acute myocardial infarction can develop after initiating or increasing the dosage of amlodipine, especially in patients with severe obstructive coronary artery disease.

Caution is recommended in patients with aortic stenosis, heart failure, and/or hepatic dysfunction.

Monitoring for symptoms of hypotension and edema is recommended when amlodipine is coadministered with CYP450 3A4 inhibitors. Blood pressure should be closely monitored when amlodipine is coadministered with CYP450 3A4 inducers.

Safety and effectiveness have not been established in pediatric patients less than 6 years of age.

Dialysis

Amlodipine is only slightly removed by hemodialysis, if at all, since it is highly protein bound.

Other Comments

When amlodipine is added to other antihypertensive therapy, a 2.5 mg starting dose is often used.

Amlodipine may be administered with or without food.

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