Can a patient take lisinopril and Norvasc (amlodipine) at the same time?

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Yes, Lisinopril and Norvasc (Amlodipine) Can and Should Be Taken Together

The combination of lisinopril (an ACE inhibitor) and amlodipine (a calcium channel blocker) is not only safe to take together but is actually one of the preferred and guideline-recommended combinations for treating hypertension. 1

Guideline Support for This Combination

  • The European Society of Cardiology explicitly recommends the combination of an ACE inhibitor (like lisinopril) and a dihydropyridine calcium channel blocker (like amlodipine) as one of the preferred combinations for treating hypertension. 1

  • The JNC 7 guidelines specifically list amlodipine-lisinopril as an available fixed-dose combination for hypertension management. 1

  • Current guidelines recommend combination therapy as initial treatment for most patients with confirmed hypertension (BP ≥140/90 mmHg). 1

Why This Combination Works Well

  • These medications provide complementary mechanisms of action: lisinopril blocks the renin-angiotensin system while amlodipine affects calcium-dependent vascular smooth muscle contraction, resulting in more effective blood pressure reduction than either medication alone. 1

  • The combination allows for lower doses of each individual drug, potentially reducing side effects while maintaining efficacy. 1

  • Clinical studies demonstrate that the combination of 2.5 mg amlodipine with 5 mg lisinopril produces significantly more blood pressure lowering in a higher percentage of patients than individual low doses. 2

  • In a study of 24 patients, 5 mg amlodipine and 10 mg lisinopril monotherapy achieved target blood pressure in 71% and 72% of patients respectively, but the combination was even more effective. 2

Administration Guidance

  • Both medications can be taken at the same time of day. The European Society of Cardiology recommends taking medications at the most convenient time for the patient to establish a habitual pattern and improve adherence. 1

  • Fixed-dose single-pill combinations containing these medication classes are available and recommended to improve adherence. 1

Important Safety Considerations

  • This combination is safe and does NOT fall under the contraindicated category of "dual RAS blockade." The guidelines that warn against combining two RAS blockers (such as an ACE inhibitor with an ARB) do not apply to this combination, as amlodipine is a calcium channel blocker, not a RAS blocker. 3

  • Both regimens are generally well tolerated with adverse events typically mild to moderate in severity. 4

  • Monitor for additive hypotensive effects, particularly when initiating therapy or increasing doses. 1

  • Black patients may have a higher risk of angioedema with ACE inhibitors, and Asian Americans have a higher incidence of ACE inhibitor-induced cough. 1

Clinical Efficacy Data

  • After 6 months of treatment with lisinopril and amlodipine combination, studies show significant improvements in hemodynamic parameters while achieving target blood pressure. 5

  • In patients with stage 2 hypertension, the combination achieved significant reductions in blood pressure with response rates of 95-100% and DBP control rates of 77-80%. 4

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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