Statistical Modeling of Intermittent Amlodipine Dosing Using Monte Carlo Simulation and Real-World Blood Pressure Data

Hypertension affects over 1.28 billion adults worldwide, yet treatment adherence remains low. Amlodipine, a calcium channel blocker with a long half-life, is commonly prescribed once daily, but many patients self-modify their dosing schedules. This study evaluated the effect of intermittent amlodipine dosing on blood pressure (BP) control using real-world data and Monte Carlo simulation. Blood pressure readings were collected over three months from a patient on varying dosing regimens (once daily [QD], once every other day [QOD], once every 2 days [Q2D], once weekly [Q7D], and once every 10 days [Q10D]). Statistical comparison showed no significant difference in systolic or diastolic blood pressure among dosing regimens. Monte Carlo simulations (N=1000) revealed normally distributed systolic BP values with overlapping distributions across dosing schedules. Predicted proportions of systolic BP exceeding 120 mmHg ranged from 12.2% to 27.2%, while SBP >140 mmHg occurred only twice across all regimens. Coefficient of variation for SBP was <10% in all scenarios. Findings suggest intermittent dosing has limited impact on BP control due to amlodipine’s long half-life, supporting flexibility in individualized dosing schedules.