What is the effect of combining amlodipine (calcium channel blocker) and losartan (angiotensin II receptor antagonist)?

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From the Guidelines

Amlodipine and losartan can be safely and effectively used together as a combination therapy for hypertension, with evidence suggesting that this combination may provide better blood pressure control and reduce the risk of cardiovascular events. This combination works well because the medications control blood pressure through different mechanisms - amlodipine is a calcium channel blocker that relaxes blood vessels, while losartan is an angiotensin II receptor blocker (ARB) that prevents blood vessel constriction. According to the 2007 guidelines for the management of arterial hypertension 1, angiotensin receptor antagonists like losartan have been shown to reduce the risk of stroke and cardiovascular events in hypertensive patients. The VALUE trial, cited in the guidelines 1, compared the effects of valsartan (an ARB) and amlodipine on cardiovascular outcomes in over 15,000 hypertensive patients, and found that amlodipine-treated patients had a slightly lower blood pressure value and a significant reduction in myocardial infarction.

Some key points to consider when using this combination include:

  • Typical dosing ranges from 5-10 mg daily for amlodipine and 25-100 mg daily for losartan, usually taken once daily.
  • The combination is particularly beneficial for patients who haven't achieved target blood pressure with a single medication or those with certain comorbidities like diabetes or kidney disease.
  • Side effects may include dizziness, headache, swelling in the ankles or feet, and occasional cough (more common with ACE inhibitors than ARBs like losartan).
  • Blood pressure and kidney function should be monitored regularly when taking this combination, especially during the initial adjustment period. As noted in the guidelines 1, pooled data have shown that the benefits of angiotensin receptor antagonists for heart failure prevention are particularly large in diabetic patients, making this combination a potentially useful option for these patients.

From the Research

Amlodipine Losartan Combination

  • The combination of amlodipine and losartan has been studied in several clinical trials to evaluate its efficacy and safety in treating hypertension 2, 3, 4, 5, 6.
  • A study published in 2019 found that the combination of lisinopril, losartan, or valsartan with amlodipine was effective in reducing blood pressure and improving arterial stiffness in patients with essential hypertension 2.
  • Another study published in 2007 compared the efficacy and safety of losartan/hydrochlorothiazide and candesartan/amlodipine combinations in hypertensive patients and found that both combinations were effective in reducing blood pressure, but losartan/hydrochlorothiazide was more cost-effective and had fewer adverse effects on metabolic parameters 3.
  • A randomized, double-blind, multicenter study published in 2011 found that the combination of amlodipine and losartan was more effective than amlodipine monotherapy in reducing blood pressure in patients with stage 2 hypertension 4.
  • A study published in 2012 compared the efficacy and safety of fixed-dose amlodipine/losartan and losartan in hypertensive patients inadequately controlled with losartan and found that the combination of amlodipine and losartan was more effective in reducing blood pressure and achieving blood pressure goals 5.
  • A real-world, multicenter observational study published in 2021 found that amlodipine/losartan-based single-pill combination therapy was effective and safe in patients with hypertension, with high target blood pressure achievement rates and excellent drug adherence 6.

Efficacy of Amlodipine Losartan Combination

  • The combination of amlodipine and losartan has been shown to be effective in reducing blood pressure in patients with hypertension, with significant reductions in systolic and diastolic blood pressure 2, 3, 4, 5.
  • The combination has also been shown to improve arterial stiffness and reduce peripheral resistance in patients with essential hypertension 2.
  • The efficacy of the combination has been compared to other antihypertensive combinations, such as losartan/hydrochlorothiazide and candesartan/amlodipine, and has been found to be similar or superior in some cases 3, 4, 5.

Safety of Amlodipine Losartan Combination

  • The combination of amlodipine and losartan has been shown to be safe and well-tolerated in patients with hypertension, with few adverse effects reported 2, 3, 4, 5, 6.
  • The combination has been found to have a similar safety profile to other antihypertensive combinations, such as losartan/hydrochlorothiazide and candesartan/amlodipine 3, 4, 5.
  • A real-world, multicenter observational study found that amlodipine/losartan-based single-pill combination therapy had excellent drug adherence and few adverse effects, with no significant differences in safety endpoints among different combination therapies 6.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

Effectiveness of add-on low-dose diuretics in combination therapy for hypertension: losartan/hydrochlorothiazide vs. candesartan/amlodipine.

Hypertension research : official journal of the Japanese Society of Hypertension, 2007

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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