Amlodipine (Norvasc) Indications and Dosage
- angina
- hypertension
- variant angina
Amlodipine (Norvasc) Indications and Dosage
For the treatment of hypertension:
NOTE: The maximum hypotensive effects may require several weeks to become fully manifest.
Oral dosage:
Adults: Initially, 5 mg PO once daily. Maximum dosage is 10 mg once daily. Dosage should be adjusted based on clinical response over a period of 7 - 14 days. The usual dosage is 5 - 10 mg PO once daily.
Elderly and debilitated patients: Reduce initial dosage to 2.5 mg PO once daily, the may increase to 5 mg PO once daily. Maximum 10 mg/day, based on tolerance and clinical response.
Adolescents and children >= 6 years: The FDA-approved dosage for hypertension is 2.5 - 5 mg PO once daily. The maximum dosage studied is 5 mg/day PO.
Children < 6 years: Safe and effective use has not been established.
For the treatment of coronary artery disease (CAD):
- in patients with chronic stable angina or vasospastic angina (variant angina):
Oral dosage:
Adults: Initially, 5 - 10 mg PO once daily. The usual dosage is 10 mg PO once daily.
Elderly and debilitated patients: Initiate dosage at 5 mg PO once daily. Maximum 10 mg/day, based on tolerance and clinical response.
Adolescents and children: Safe and effective use has not been established.
- in patients with recent angiographic documentation of coronary artery disease (CAD) and without heart failure or ejection fraction < 40%:
NOTE: Based on the findings of the CAMELOT trial,
amlodipine is indicated for use in patients with recently documented CAD to reduce the risk of hospitalization due to angina and to reduce the risk of a coronary revascularization procedure.
Oral dosage:
Adults: Initially, 5 - 10 mg PO once daily. The usual dosage is 10 mg PO once daily.
Elderly and debilitated patients: Initiate dosage at 5 mg PO once daily. Maximum 10 mg/day, based on tolerance and clinical response.
Adolescents and children: Safe and effective use has not been established.
Maximum Dosage Limits:
- Adults: 10 mg/day PO.
- Elderly: 10 mg/day PO.
- Adolescents: 5 mg/day PO for hypertension.
- Children 6 - 12 years: 5 mg/day PO for hypertension.
- Children < 6 years: Safe and effective use has not been established.
Patients with hepatic impairment:
Initiate dosage at 2.5 mg PO once daily for hypertension or 5 mg PO once daily for angina; adjust dosage based on clinical response. The elimination half-life of amlodipine is significantly prolonged in patients with hepatic disease.
Patients with renal impairment:
No dosage adjustment is needed.
Intermittent hemodialysis:
Amlodipine is highly protein bound and is not likely to be significantly removed by hemodialysis.
[ Last revised: 12/14/2005 12:52:00 PM ]
References
. Norvasc® (amlodipine) package insert. New York, NY: Pfizer Labs; 2005 Mar.
. Nissen SE, Tuzcu EM, Libby P, et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA 2004;292:2217 - 25.
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