Yes, Taking a Calcium Channel Blocker and ACE Inhibitor Together is Safe and Recommended
The combination of a calcium channel blocker (CCB) and an ACE inhibitor is not only safe but is explicitly recommended as a preferred two-drug combination by multiple major international hypertension guidelines, including the American College of Cardiology, European Society of Cardiology, and JNC 8. 1, 2
Why This Combination Works Well
Complementary mechanisms of action: These two drug classes target different blood pressure control systems in your body, creating a synergistic effect that provides better blood pressure control than either medication alone. 2, 3, 4
Guideline-endorsed combination: This pairing appears consistently across all major hypertension guidelines as a preferred option:
- JNC 8 lists "CCB + ACEI" as a recommended two-drug combination 1
- ESH/ESC specifically identifies "CCB + ACEI or ARB" as a preferred combination 1
- NICE, Taiwan, and China guidelines all endorse this combination for two-drug therapy 1
- American College of Cardiology and European Society of Cardiology recommend this as one of the most effective combinations for reducing cardiovascular events 2
Clinical Benefits Beyond Blood Pressure Control
Cardiovascular protection: The ACE inhibitor + CCB combination has been shown to reduce cardiovascular events more effectively than some other combinations, with evidence suggesting it may improve endothelial function better than either agent alone. 2, 3, 4
Well-tolerated profile: This combination is notably well-tolerated, including in patients with stage 2 hypertension and elderly populations. 5, 6
Fixed-dose combinations available: Single pills containing both medications are available and can improve medication adherence. 2
Practical Considerations
Type of CCB matters slightly: Dihydropyridine CCBs (like amlodipine, nifedipine) are most commonly combined with ACE inhibitors, though non-dihydropyridine CCBs (verapamil, diltiazem) can also be used with different side effect profiles. 2
Monitoring requirements: Blood pressure should be monitored after starting this combination, especially during the first month of therapy. 2
Do not abruptly stop: Avoid sudden discontinuation of either medication due to potential rebound effects. 2
Special Populations Where This Combination Excels
This combination is particularly recommended for:
- Patients with diabetes 2
- Chronic kidney disease with albuminuria 2
- High cardiovascular risk patients 2
- Black patients (after initial therapy) 2
- Elderly patients (with careful dose adjustment) 2
Critical Safety Note: What NOT to Combine
Never combine two RAAS blockers: Do NOT take an ACE inhibitor together with an ARB (angiotensin receptor blocker) or direct renin inhibitor (like aliskiren), as this increases risk of hyperkalemia, syncope, and acute kidney injury without additional benefit. 7 This is a completely different issue from combining an ACE inhibitor with a CCB, which is safe and recommended.