Amlodipine alternatives: What can I take instead of amlodipine?

Compare amlodipine alternatives | Nifedipine | Lisinopril | Losartan | Carvedilol | Hydrochlorothiazide | Natural alternatives | How to switch meds

Amlodipine is a generic medication prescribed to treat high blood pressure. In addition to treating high blood pressure, amlodipine is approved to treat angina and other problems with coronary artery disease. Amlodipine is also known by the brand name Norvasc. It works as a calcium channel blocker (CCB) that relaxes the blood vessels to reduce stress on the heart and allow blood to pump more freely. 

In some cases, an amlodipine alternative may be recommended if amlodipine is ineffective or causing side effects. One of the most common side effects of amlodipine is edema, or swelling in the hands, legs, or feet. There are several alternatives to amlodipine available, including other CCBs, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta blockers, and diuretics. 

Continue reading to learn more about amlodipine alternatives and how they stack up against amlodipine. 

What can I take in place of amlodipine?

The recommended amlodipine alternative will depend on the reason you need to discontinue amlodipine. If your blood pressure remains uncontrolled with amlodipine, a healthcare provider may recommend adding another medication on top of amlodipine. If you are experiencing intolerable side effects from amlodipine, a healthcare provider may recommend switching to a different CCB or other medication. 

An alternative to amlodipine may be prescribed depending on the condition being treated, other conditions you may have, and your overall health. Some alternatives may be better for certain conditions than others. For example, if you have coronary artery disease in addition to high blood pressure, a healthcare provider might recommend a beta blocker instead of a different medication. 

Other alternatives to amlodipine

• Vasexten (barnidipine)
• Zanidip (lercanidipine) 
• Plendil (felodipine)
• Adalat CC, Procardia (nifedipine)
• Cardene SR (nicardipine)
• Lotensin (benazepril) 
• Vasotec, Epaned (enalapril)
• Altace (ramipril)
• Aceon (perindopril) 
• Atacand (candesartan)
• Lopressor (metoprolol tartrate)
• Toprol XL (metoprolol succinate)
• Coreg (carvedilol)
• Diuril (chlorothiazide) 
• Thialitone, Hygroton (chlorthalidone) 
• Microzide (hydrochlorothiazide)

Top 5 amlodipine alternatives

1. Other calcium channel blockers (such as nifedipine, diltiazem, or verapamil)

Amlodipine is a dihydropyridine CCB that primarily works on the blood vessels. Other dihydropyridine CCBs include nifedipine, felodipine, lercanidipine, and barnidipine. Studies suggest that lercanidipine has a lower risk of causing edema as a side effect than amlodipine. Other studies show that barnidipine is similarly effective to amlodipine without causing intolerable side effects. 

Diltiazem and verapamil are non-dihydropyridine CCBs that have greater effects on the heart than dihydropyridine CCBs. These types of CCBs may be a good alternative to amlodipine when used to treat angina instead of high blood pressure. 

2. ACE Inhibitors (such as lisinopril, ramipril, or benazepril)

ACE inhibitors are potential alternatives to CCBs. They are effective blood pressure medications approved by the FDA. These drugs work by blocking an enzyme that helps produce angiotensin II, a chemical that leads to the narrowing of blood vessels. By blocking the production of angiotensin II, ACE inhibitors can relax the blood vessels and lower blood pressure. ACE inhibitors are commonly prescribed first-line agents for high blood pressure, although they can also be used to treat other conditions like heart failure and heart attacks. 

3. ARBs (such as losartan, telmisartan, or candesartan)

ARBs are high blood pressure medications that work by blocking the effects of angiotensin II. More specifically, they block the angiotensin II receptors to prevent the actions of angiotensin II. The result is widened and relaxed blood vessels, which leads to lower blood pressure. Examples of ARBs include losartan and candesartan. These medications are effective alternatives to amlodipine, especially in people who may be allergic to amlodipine. 

4. Beta blockers (such as carvedilol, metoprolol, or bisoprolol)

Beta blockers work by blocking the effects of certain hormones, such as adrenaline (epinephrine), which helps the heart beat slower and with less force. They are often prescribed to treat cardiovascular problems like angina and high blood pressure. Because of their effects on heart rate, beta blockers can also help treat heart problems like atrial fibrillation (AFib). Examples of beta blockers include atenolol and bisoprolol. 

5. Diuretics (such as hydrochlorothiazide)

Thiazide-like diuretics are a commonly prescribed alternative to amlodipine. Studies and guidelines find that CCBs or diuretics are more effective than other blood pressure medications in Black or older people. They work by blocking the reabsorption of sodium and water in the kidneys, which increases urination and decreases overall blood volume to help lower blood pressure. Examples of diuretics include indapamide, hydrochlorothiazide, and chlorthalidone.

Natural alternatives to amlodipine

There are no herbal or dietary supplements approved to treat high blood pressure, and healthcare providers rarely recommend anything but prescription medications and lifestyle changes for high blood pressure. However, some studies show that certain supplements may help support healthy blood pressure. 

Limit sodium intake

The American Heart Association (AHA) recommends restricting sodium intake to 2,300 mg, or ideally 1,500 mg, per day. To clarify, 2,300 mg of sodium is equal to about 1 teaspoon of table salt. Some people may need even less sodium to manage their blood pressure.  

Exercise

Being overweight or obese is linked to an increased risk of high blood pressure. Managing your weight and exercising are recommended ways to help control blood pressure. Studies have shown that aerobic exercise at least three times a week (or ideally, most days of the week) helps lower systolic and diastolic blood pressure. 

Diet 

Healthcare providers often recommend what’s known as the DASH (Dietary Approaches to Stop Hypertension) diet to help lower blood pressure. This diet incorporates eating more fruits, vegetables, and whole grains, as well as lean sources of protein like fish and chicken. The DASH diet limits intake of red meats, full-fat dairy products, and foods high in saturated fats, sugar, and sodium. 

Quit smoking

Cigarettes and other tobacco products contain nicotine, which can constrict the blood vessels and increase blood pressure. Quitting smoking can help normalize blood pressure and reduce stress on the heart. 

Limit alcohol and caffeine

Excess alcohol consumption may lead to high blood pressure in the long run. Try to consume alcohol in moderation, or no more than two drinks per day for men or one drink per day for women. While not entirely significant, caffeine can lead to short-term increases in blood pressure. You may want to watch your caffeine intake, especially if you have uncontrolled, high blood pressure. 

Supplements

Potassium, magnesium, and dietary fiber may help manage blood pressure. A healthcare provider may recommend following a diet rich in potassium, magnesium, and dietary fiber, in addition to prescription medications. Other supplements that may help lower blood pressure include:

• Coenzyme Q10
• Garlic
• Fish oil
• Ginger
• Flaxseed
• Vitamin C
• Probiotics

More conclusive studies are needed to determine the effect of these supplements on high blood pressure. It’s important to talk to a healthcare provider before taking a supplement for high blood pressure. 

How to switch to an amlodipine alternative

The process for switching blood pressure medications will vary depending on your blood pressure and overall condition. The primary reason for switching to a different antihypertensive is uncontrolled blood pressure. 

In many cases, a healthcare provider will first recommend increasing the dose of your amlodipine if your blood pressure is uncontrolled. If that doesn’t work, they may add another medication to your blood pressure treatment regimen. In people with hard-to-treat high blood pressure and other medical conditions, combination therapy is usually recommended. People who are allergic to amlodipine or experiencing intolerable side effects from amlodipine may be switched to another CCB or blood pressure medication. 

Before switching to an amlodipine alternative, seek medical advice from your healthcare provider. Your healthcare provider will want to evaluate your overall medical condition before switching you to a different medication. When switching to an alternative medication, it will also be important to consider possible side effects and drug interactions if you have other medical conditions and are taking other medications.