Usual Adult Dose for Hypertension

Initial dose:
Immediate-release capsules: 2.5 mg orally twice a day
Controlled-release tablets: 5 mg orally once a day

Maintenance dose: The dose may be adjusted as needed and tolerated in increments of 5 mg at 2 to 4 week intervals.

The maximum recommended daily dose for the immediate-release capsules is 20 mg, although most patients show no additional response to doses above 10 mg/day. The maximum recommended dose for the controlled-release tablets is 20 mg/day.

Renal Dose Adjustments

Mild renal impairment:
Initial dose: No adjustment recommended.

Liver Dose Adjustments

Hepatic functional impairment:
Initial dose: No adjustment recommended.

Precautions

Caution is recommended when using isradipine in congestive heart failure patients, especially when coadministered with a beta-blocker.

As with any other nondeformable material, caution should be used when administering controlled-release isradipine tablets in patients with preexisting severe gastrointestinal narrowing (pathologic or iatrogenic).

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Isradipine is not removed by hemodialysis. If isradipine is administered after hemodialysis, doses should be administered when the patient is hemodynamically stable to decrease the risk of hypotension.

Other Comments

Adverse effects are increased in frequency above 10 mg/day.