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Key takeaways
Amlodipine besylate, a calcium channel blocker used to treat hypertension, may cause side effects like peripheral edema and postural hypotension, leading some patients to seek alternatives.
Alternatives to amlodipine besylate include other calcium channel blockers, ACE inhibitors, ARBs, beta blockers, and various other antihypertensive medications, each with its own benefits and potential side effects.
Lifestyle modifications such as weight loss, the DASH diet, reduced sodium intake, and increased physical activity are recommended alongside or before medication for managing hypertension.
Switching from amlodipine besylate to an alternative medication should be done under the guidance of a healthcare provider to avoid dangerous rises in blood pressure and ensure proper treatment selection.
Amlodipine besylate, known by the brand-name Norvasc, is a prescription medication used primarily to treat hypertension, otherwise known as high blood pressure. Hypertension affects almost half of all adults in the United States, a staggering statistic. If left untreated, hypertension can cause long-term cardiovascular damage throughout your body and to many organs. Heart attacks, heart failure, and kidney disease are just some of the long-term complications of hypertension. It typically takes a multi-step approach of healthy eating, exercise, and medication therapy to control hypertension for most patients. Amlodipine besylate is one such medication to treat hypertension.
Amlodipine besylate is a prescription medication belonging to a class of medications known as calcium channel blockers. This class of drugs works by inhibiting calcium channels at the cellular level, blocking calcium from entering the cells. Ultimately, this limits the contraction of the heart and vascular smooth muscle, meaning your heart rate is lowered, and there is less resistance in your blood vessels for your heart to pump against. Your heart is able to slow down, and better blood flow of oxygenated blood reaches your organs, leading to better health outcomes and a lower risk of heart disease.
There are two general types of calcium channel blockers: dihydropyridines (DHPs) and non-dihydropyridines (non-DHPs). DHPs have an affinity for the calcium channels in the smooth muscles of the vasculature and are more appropriate for treating hypertension. Non-DHPs have an affinity for the calcium channels of the heart muscle and are, therefore, more appropriate for correcting heart rhythms, otherwise known as arrhythmias. Amlodipine besylate is a DHP calcium channel blocker most appropriately indicated for hypertension.
Because DHPs have an affinity for the vascular system in your periphery or extremities (a fancy way of saying your arms and legs), some side effects can be bothersome. Peripheral edema, or the pooling of fluid (typically in the lower legs), can occur. Postural hypotension, which is better known as dizziness upon standing or lightheadedness, as well as headaches, can occur. These can be cumbersome enough that a person may not want to continue therapy with amlodipine besylate and may wish to seek alternative therapies. While you should never stop taking your prescribed medication without first reaching out to your prescriber, there are other calcium channel blockers and other antihypertensive medication classes of drugs you can discuss with your provider to see if one is a viable alternative for you.
RELATED: Amlodipine side effects and how to avoid them
What can I take in place of amlodipine besylate?
The first option you may want to explore with your provider is an alternative calcium channel blocker. Plendil (felodipine) and Dynacirc CR (isradipine) are other DHP calcium channel blockers. However, if you have a history of arrhythmia, a non-DHP calcium channel blocker should be discussed, such as Cardizem LA (diltiazem).
If the common side effects of calcium channel blockers are not tolerable for you, or your blood pressure is not adequately controlled with calcium channel blockers alone, you may need to replace or add to the therapy. There are many other classes of blood pressure medications. The Joint National Committee (JNC) publishes guidelines for treating blood pressure, which your healthcare provider may use to guide their decision-making. Other antihypertensive medications that are used include ACE (angiotensin-converting enzyme) inhibitors, angiotensin receptor blockers, beta blockers, diuretics, and other categories and combinations of drugs. There are hundreds of strengths and combinations of drugs to choose from when treating hypertension.
Below are some examples of amlodipine besylate alternatives. While this is not intended to be a comprehensive list, it can be a good starting point to give you some alternatives to discuss with a medical professional. Not all therapies are safe when pregnant or breastfeeding, so if you are planning to be pregnant or already are, be sure to discuss this with your doctor, as heart health is more important than ever when you are pregnant. This is not intended to be medical advice. Your cardiology specialist can help determine what is right for you.
Compare amlodipine besylate alternatives |
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|---|---|---|---|
| Drug name | Uses | Dosage | Savings options |
| Norvasc (amlodipine besylate) | Hypertension, angina, variant angina | 2.5 mg – 10 mg by mouth once daily | Amlodipine besylate coupons |
| Cardizem LA (diltiazem) | Hypertension, angina, unstable angina, variant angina, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia | 120 mg – 540 mg by mouth once daily | Cardizem LA coupons |
| Calan SR (verapamil sustained release) | Hypertension, angina, unstable angina, variant angina, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), PSVT prophylaxis | 80 mg – 320 mg by mouth twice daily | Calan SR coupons |
| Procardia XL (nifedipine) | Hypertension, angina, variant angina, hypertensive urgency (off-label), hypertensive emergency (off-label) | 30 mg – 60 mg by mouth once daily | Procardia XL coupons |
| Plendil (felodipine) | Hypertension, angina | 2.5 mg – 20 mg by mouth once daily | Plendil coupons |
| Dynacirc CR (isradipine) | Hypertension | 2.5 mg – 10 mg by mouth twice daily | Dynacirc CR coupons |
| Zestril (lisinopril) | Hypertension, heart failure, reduction of mortality after acute myocardial infarction | 10 mg – 40 mg by mouth once daily | Zestril coupons |
| Lotensin (benazepril) | Hypertension | 10 mg – 40 mg by mouth once daily | Lotensin coupons |
| Cozaar (losartan) | Hypertension, stroke prophylaxis in hypertensive patients with left ventricular hypertrophy (LVH) | 25 mg – 100 mg by mouth once to twice daily | Cozaar coupons |
| Benicar (olmesartan) | Hypertension | 20 mg – 40 mg by mouth once daily | Benicar coupons |
| Diovan (valsartan) | Hypertension, heart failure | 80 mg – 320 mg by mouth once to twice daily | Diovan coupons |
| Tenormin (atenolol) | Angina pectoris, hypertension | 25 mg – 100 mg by mouth once daily | Tenormin coupons |
| Lopressor (metoprolol) | Angina pectoris, hypertension, heart failure | 50 mg – 100 mg by mouth once to twice daily | Lopressor coupons |
| Coreg (carvedilol) | Hypertension, heart failure | 12.5 mg – 50 mg by mouth twice daily | Coreg coupons |
| Cardura (doxazosin) | Hypertension, benign prostatic hyperplasia (BPH) | 1 mg – 16 mg by mouth once daily | Cardura coupons |
Other alternatives to amlodipine besylate
- Inderal LA (propranolol)
- Altace (ramipril)
- Atacand (candesartan)
- Micardis (telmisartan)
- Isoptin SR (verapamil long-acting)
- Minipress (prazosin)
- Catapres (clonidine)
Top 5 amlodipine besylate alternatives
The following are some of the most common alternatives to amlodipine besylate.
1. Other calcium channel blockers
If amlodipine besylate is not the right calcium channel blocker for you, it is possible that other calcium channel blockers could be appropriate for you. Peripheral edema is more prominent with amlodipine besylate than with any other calcium channel blocker. Therefore you may tolerate the side effects of other calcium channel blockers much better than amlodipine besylate. In this case, switching to another DHP calcium channel blocker, such as Procardia XL, may be beneficial.
Examples: Procardia XL (nifedipine), Plendil (felodipine), Dynacirc CR (isradipine)
2. Angiotensin converting enzyme (ACE) inhibitors
ACE inhibitors are a first-line option for treating hypertension. They can be used alone or in combination with other antihypertensive drug types. They work by blocking the action of the vasoconstricting effect of angiotensin. There are many ACE inhibitors on the market, and all are relatively equal in terms of therapeutic effect. ACE inhibitors have a relatively low incidence of side effects and are generally cost-effective. For some, a persistent cough can develop when taking an ACE inhibitor. If this occurs, speak to your doctor about finding an alternative therapy.
Examples: Zestril (lisinopril), Altace (ramipril), Lotensin (benazepril), Vasotec (enalapril)
3. Angiotensin II receptor blockers (ARBs)
Angiotensin II receptor blockers block the effects of angiotensin, though in a different manner than ACE inhibitors. Ultimately, the effect is similar: vasodilation that results in lowered resistance and blood pressure. The side effect profile of ARBs is also very mild as they are typically very easy to tolerate. This is a good alternative for those who develop a cough with ACE inhibitors. ARBs can be used alone or with other medications to treat high blood pressure.
Examples: Cozaar (losartan), Benicar (olmesartan), Diovan (valsartan)
4. Beta blockers
Beta blockers are typically used in patients with angina (chest pain) and a diagnosis of heart failure. They can be used to treat hypertension as well. Beta-blockers work by slowing the speed at which the heart beats as well as the forcefulness with which it beats. People taking beta blockers report adverse effects such as feeling tired and lethargic, which is one of the primary reasons they will report discontinuing treatment. Beta-blockers may be used in combination with other antihypertensive drugs. There are different types of beta blockers that have different preferences for certain tissue types, which makes them useful in various types of cardiovascular diseases.
Examples: Coreg (carvedilol), Lopressor (metoprolol), Tenormin (atenolol)
5. Other hypertension drug alternatives
There are still many other drug classes that can be used to treat hypertension, including thiazide diuretics, loop diuretics, potassium sparing diuretics, alpha-1 blockers, alpha-2 agonists, and numerous combination products. Ultimately, the appropriate use of these medications can be determined by a combination of clinical presentation, lab values, possible side effects, and response to other therapies.
Examples: Lasix (furosemide), HydroDIURIL (hydrochlorothiazide), Cardura (doxazosin), Catapres (clonidine)
Natural alternatives to amlodipine besylate
Your healthcare provider may make several lifestyle modification suggestions when treating your hypertension. In fact, if your hypertension is mild upon discovery, they may try these modifications alone without medication initially to see if your blood pressure can be lowered adequately.
Typically, the first recommendation made when it is relevant is reducing body weight. By losing 10 kg, your systolic blood pressure could be lowered by up to 20 mmHg. This could make a substantial difference if your blood pressure was only mildly elevated to begin with. Many prescribers and the American Heart Association also recommend the DASH diet, which stands for “Dietary Approaches to Stop Hypertension.” It is generally based on limiting foods high in sugar and fat and getting more vegetables and grains in your diet. This diet can help you achieve healthy cholesterol and weight maintenance as well. As a general rule, individuals with hypertension should limit their sodium intake, as sodium can increase fluid retention, which can increase blood pressure. Increased exercise and physical activity are almost always part of any lifestyle modification plan aimed at lowering blood pressure when the person is able to do so. Lifestyle changes are a key component to keeping your blood pressure under control.
Some has shown that magnesium as an over-the-counter supplement can lower blood pressure; however, it shows no significant effect. is a natural calcium channel blocker that works similarly to amlodipine besylate. While it may not be harmful, insufficient evidence supports it being a substitute or replacement for amlodipine besylate or any other FDA-approved antihypertensive treatment options. Your healthcare provider may discuss its use as a supplement with you.
RELATED: How to lower blood pressure quickly and naturally
How to switch to an amlodipine besylate alternative
If you feel that amlodipine besylate may not be the proper medication for you, do not stop taking it without speaking to your healthcare provider first. Your blood pressure could rise dangerously if it is not being treated at all. Be prepared to talk openly with your provider about your experience with amlodipine besylate, including side effects, blood pressure readings, insurance coverage, and any other factors influencing your decision.
If your concern is price or insurance coverage, your insurance company or pharmacist can help answer questions about amlodipine besylate or any alternatives you are considering. SingleCare provides excellent information on drug pricing. A SingleCare prescription discount card can help you get the lowest possible price on any prescription drug at participating pharmacies.
