Amlodipine Dose Calculator

Indication

Starting or maintenance?

Hepatic impairment?

Amlodipine Dose

—

Tablet

—

BP target

<130/80 mmHg

Onset

—

Max dose

10 mg/day

⚠️

ℹ️

🚫

💊 Drug profile

ClassDihydropyridine CCB

Onset6–12 hours (gradual)

Peak effect6–12 hours

Half-life30–50 hours

Renal adj.Not required

Hepatic imp.Start 2.5 mg; titrate slowly

🏷️ Indian brands

2.5 mgAmlokind 2.5 · Amlong 2.5

5 mgAmlokind 5 · Amlong · Stamlo · Amlip

10 mgAmlokind 10 · Amlong 10 · Stamlo 10

+ AtenololAmlopress-AT · Amlopres-Z

+ TelmisartanTelma-AM · Telmikind-AM

+ AtorvastatinCaduet (5/10mg aml + 10/20mg atv)

⚠️ Key cautions

⚠️ Ankle oedema (up to 10–15%) — counsel upfront

⚠️ Grapefruit juice — avoid (increases levels)

⚠️ Simvastatin: cap simvastatin at 20mg/day when combined with amlodipine

⚠️ Heart failure: use with caution (prefer amlodipine over other CCBs — proven safe)

✓ Safe in CKD — no dose adjustment needed

✓ Safe in asthma — preferred over beta-blockers

Amlodipine — Clinical Guide India

Amlodipine is a third-generation dihydropyridine calcium channel blocker (CCB) and one of the most commonly prescribed antihypertensives in India. Its very long half-life (30–50 hours) allows once-daily dosing, making it one of the most convenient and adherence-friendly antihypertensives available. It is a first-line choice for hypertension in patients with diabetes, CKD, angina, and those of African or South Asian descent (CCBs are particularly effective in Indian patients). Available generically as Amlong, Stamlo, Amlokind, and Amlip in 5 mg and 10 mg tablets.

Ankle oedema — the most common reason for stopping

Ankle (peripheral) oedema is the most common side effect of amlodipine, occurring in up to 10–15% of patients at 5 mg and up to 30% at 10 mg. It results from precapillary arteriolar vasodilation increasing hydrostatic pressure in leg capillaries — it is not a sign of heart failure or kidney disease. Counsel every patient starting amlodipine: mild ankle swelling is expected and does not mean the drug has harmed the heart or kidneys. Elevating legs, reducing dietary sodium, and adding an ACE inhibitor or ARB (which counteract the peripheral vasodilation) can significantly reduce CCB-induced oedema. Diuretics are less effective for CCB oedema than for cardiac oedema.

Combination therapy with amlodipine in India

Amlodipine is commonly combined with other antihypertensives in fixed-dose combination (FDC) tablets widely available in India: amlodipine + telmisartan (Telma-AM), amlodipine + atenolol (Amlopress-AT), amlodipine + ramipril, and amlodipine + atorvastatin (Caduet). These combinations improve adherence and are cost-effective for Indian patients. The amlodipine + ACEi/ARB combination is the most evidence-based pairing — it reduces CCB-induced oedema and provides complementary BP-lowering through different mechanisms. The amlodipine + atenolol combination is effective but requires care in patients with bradycardia or heart block.

Simvastatin interaction — dose cap is essential

Amlodipine inhibits CYP3A4 and increases plasma simvastatin levels by up to 77%, significantly increasing the risk of myopathy and rhabdomyolysis. The maximum safe dose of simvastatin when combined with amlodipine is 20 mg/day. Patients on amlodipine who require a higher statin dose should switch to rosuvastatin or pravastatin (not metabolised by CYP3A4) instead of high-dose simvastatin. This combination is particularly important to screen for in India where simvastatin remains widely prescribed.

Frequently Asked Questions

Can amlodipine be taken at any time of day?+

Yes. Unlike some antihypertensives, amlodipine can be taken at any consistent time of day — morning, evening, or bedtime. Its very long half-life (30–50 hours) means timing relative to meals does not significantly affect absorption, and once-daily dosing at any regular time provides smooth 24-hour BP control. Some evidence supports evening dosing for slightly better nocturnal BP control, but adherence to a consistent daily habit is more important than timing.

Is amlodipine safe in pregnancy?+

Amlodipine is generally avoided in pregnancy — it is classified as Pregnancy Category C. There is limited human data on safety and animal studies show embryotoxicity at high doses. Safer alternatives for hypertension in pregnancy: methyldopa (most established safety record), labetalol (oral or IV), or nifedipine (particularly for acute severe hypertension). Amlodipine should be stopped when pregnancy is confirmed and switched to a pregnancy-safe antihypertensive under obstetric guidance.

Why is amlodipine preferred over other CCBs in heart failure?+

Short-acting dihydropyridine CCBs (nifedipine IR) and non-dihydropyridine CCBs (verapamil, diltiazem) are contraindicated in heart failure with reduced ejection fraction (HFrEF) — they worsen cardiac function. Amlodipine is the only CCB proven safe in heart failure by the PRAISE trial (Prospective Randomised Amlodipine Survival Evaluation). When a CCB is genuinely needed for angina or BP control in a heart failure patient, amlodipine is the appropriate choice. It should still be used cautiously and the primary heart failure medications (beta-blocker, ACEi/ARB, mineralocorticoid antagonist) should be optimised first.

⚠️Amlodipine is not suitable for acute hypertensive emergencies — its slow onset makes it inappropriate for rapid BP reduction. Use IV labetalol, IV hydralazine, or sublingual nifedipine (with caution) for hypertensive urgency/emergency. Verify against BNF and JNC/ISH guidelines.

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