From the Guidelines
Taking amlodipine and lisinopril together is often beneficial for blood pressure management, as this combination provides complementary effects, potentially offering better blood pressure control than either medication alone. These medications work through different mechanisms - amlodipine is a calcium channel blocker that relaxes blood vessels, while lisinopril is an ACE inhibitor that prevents the formation of a hormone that narrows blood vessels 1. The combination of an ACE inhibitor and a calcium channel blocker is a common and effective approach to managing hypertension, as supported by the 2013 ESH/ESC guidelines for the management of arterial hypertension, which suggest that combination therapy may be the initial approach in certain cases 1.
Key Considerations
- The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure lists various combination drugs for hypertension, including ACEIs and CCBs, but does not specifically mention amlodipine and lisinopril as a fixed-dose combination 1.
- The 2013 ESH/ESC guidelines highlight the advantages of initiating treatment with combination therapy, including a prompter response in a larger number of patients and a greater probability of achieving the target BP in patients with higher BP values 1.
- Common side effects of this combination include dizziness, swelling in the ankles, dry cough, and rarely, more serious effects like angioedema.
- It's essential to stay hydrated and monitor for excessive drops in blood pressure, especially when starting this combination.
Dosage and Administration
- Typically, amlodipine and lisinopril are taken once daily, though timing may vary based on your doctor's instructions.
- Some patients take both in the morning, while others may be advised to take one in the morning and one in the evening.
- Always follow your doctor's specific dosing instructions, as they will determine the appropriate doses based on your individual health needs and response to treatment.
From the Research
Combination Therapy with Amlodipine and Lisinopril
- The combination of amlodipine and lisinopril has been shown to have a significant additional blood pressure-lowering effect compared to either drug alone 2, 3.
- Studies have demonstrated that the combination of amlodipine and lisinopril is well tolerated and effective in achieving blood pressure goals in patients with essential hypertension 2, 3.
- The combination of amlodipine and lisinopril has been found to be more effective than monotherapy with either drug in achieving target blood pressure levels 2, 3.
Efficacy of Combination Therapy
- A study found that the combination of 2.5 mg amlodipine with 5 mg lisinopril produced a significant lowering of blood pressure in a higher percentage of patients than individual low-dose therapy 2.
- Another study demonstrated that the combination of amlodipine and lisinopril had a marked additional effect on blood pressure compared to either drug alone, with a significant fall in blood pressure at both peak and trough levels 3.
Predictors of Response to Combination Therapy
- The response to lisinopril has been found to be related to baseline plasma renin activity, while the response to amlodipine is independent of baseline renin activity 3.
- The blood pressure response to amlodipine has been found to be associated with the severity of hypertension, with greater responses seen in patients with higher initial blood pressure levels 3.
Comparison with Other Therapies
- A study found that the addition of a diuretic (bendrofluazide) to amlodipine and lisinopril was more effective than the addition of a beta-blocker (atenolol) in patients not controlled on combination therapy 4.
- Another study compared the combination of amlodipine plus valsartan with lisinopril plus hydrochlorothiazide and found that both regimens were well tolerated and efficacious in achieving blood pressure goals in patients with stage 2 hypertension 5.