Can you take losartan and amlodipine together?

In this article:

• Losartan and amlodipine
• Benefits
• Risks
• Dosage timing
• The bottom line

In this article

• Losartan and amlodipine
• Benefits
• Risks
• Dosage timing
• The bottom line

According to the CDC, nearly half of all U.S. adults have high blood pressure, but only one out of every four has it under control. Fortunately, there are many solutions, from healthy eating to exercise to an entire range of antihypertensive drugs. Two common options are losartan and amlodipine, which each help manage blood pressure in different ways. 

Can you take them together? Yes, they’re safe to take simultaneously for most people. We’ve got all the details below. 

Can you take losartan and amlodipine together?

We should always be cautious about mixing drugs, especially ones that might have similar effects on the body. But while losartan and amlodipine both help rein in hypertension, they do so in different ways. So not only is it usually safe to take them together—sometimes it’s even more effective.

“Amlodipine is a calcium channel blocker which is involved in the regulation of the constriction and relaxation of the smooth muscle cells in the blood vessels,” says Dr. Mary Greene, MD, a cardiologist with Manhattan Cardiology and contributor to www.labfinder.com. “Losartan is an angiotensin receptor blocker, which blocks the effects of the hormone angiotensin, a hormone that acts on the kidneys to increase blood pressure.” So the two drugs don’t interfere with each other, and in fact, they’re paired up so often that they’re sometimes combined in a single pill.

In a study from 2006, researchers called the combination of amlodipine and losartan “an excellent option for the treatment of a wide range of hypertensive patients.” And more recent research backs that up, like a 2021 study from Korea in The Journal of Clinical Hypertension, which also demonstrated the combo’s safety and effectiveness. Additionally, the FDA hasn’t listed any known interactions for the medications on the losartan or amlodipine labels.

This assumes, of course, that you’re only taking losartan and amlodipine together when they’ve been prescribed by a doctor and in the recommended doses.

Benefits of taking losartan and amlodipine together

The most significant benefit of taking losartan and amlodipine simultaneously is that it’s more effective than taking either one by itself. A 2011 study showed that the combination is more effective than amlodipine monotherapy, while one from 2023 demonstrated that it’s more effective than taking losartan alone.

Per Dr. Greene, “If one has blood pressure that is not controlled on one of these medications alone, adding a second medication of a different class of medications may aid in attacking what’s causing high blood pressure through separate, distinct mechanisms.” So doctors may choose this fixed-dose combination therapy for patients whose hypertension doesn’t respond well to single-drug treatment. 

But there’s more. According to Dr. John Lowe, MD, a physician at Restore Care, “Combining the two drugs may help achieve the same therapeutic result at a lower dose and, therefore, minimize dose-related side effects.”

Hypertension takes a toll on other parts of the body, and it’s a major risk factor for cardiovascular diseases. So, by lowering blood pressure, these drugs may lead to several other benefits. For example, research suggests that losartan can lower the incidence of stroke, heart failure, cardiovascular death, and even diabetes. Likewise, amlodipine can protect against stroke and heart attack.

Additionally, both drugs help protect the kidneys. Losartan has shown that it can slow renal disease, and other research says that amlodipine can improve the quality of life and protect renal function in patients with chronic kidney disease.

Risks of combining losartan and amlodipine

If losartan-amlodipine antihypertensive therapy is taken as directed, there are few serious risks. That said, “the combination can occasionally cause the blood pressure to fall too low, especially in elderly patients or patients experiencing dehydration,” Dr. Lowe says. That’s why “these medications require frequent supervision when they are started or changed to achieve the target blood pressure without complication.”

Additionally, both drugs have potential side effects and interactions that are important to know.

Losartan side effects

The most common side effects of losartan when using it for the treatment of hypertension are upper respiratory infections, dizziness, stuffy nose, back pain, cough, muscle pain, and upset stomach. In rare cases, it may cause serious side effects such as dangerously low blood pressure, high potassium levels, kidney injury, muscle damage, irregular heartbeat, or severe allergic reactions.

Losartan drug interactions

While amlodipine is a safe addition, combining losartan with other drugs may cause worrisome interactions. These drugs include:

• Potassium-sparing diuretics and loop diuretics
• Beta blockers
• Calcineurin inhibitors
• Lithium
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Angiotensin-converting enzyme (ACE) inhibitors

• Other angiotensin II receptor blockers (ARBs)

Amlodipine side effects

Amlodipine has its own set of side effects to consider. The most common is swelling of the hands, feet, and lower legs (peripheral edema). However, other possible adverse events include palpitations, flushing, fatigue, dizziness, nausea, stomach pain, skin rash, itching, and muscle cramps. Rarer, more serious side effects of amlodipine include irregular heartbeat, chest pain, and fainting.

Amlodipine drug interactions

Amlodipine may interact with the following drugs:

• Statins
• Phosphodiesterase-5 inhibitors
• Benzodiazepines
• Antipsychotics
• Opioids
• CYP3A4 inhibitors
• Immunosuppressants

Before starting losartan or amlodipine, talk with your healthcare provider about all prescription drugs, over-the-counter medications, and supplements you take.

Can I take losartan in the morning and amlodipine at night?

Technically, you can take either drug at any time of day, either together or separately. But if you’re looking for the optimal time, the research varies. An older study on amlodipine from 2003 concluded that it’s best to take antihypertensive agents in the morning, claiming it was better for circadian blood pressure than evening administration.

But that’s not always the case, and losartan is a different story. “Losartan is in a class of medications called ARBS (angiotensin receptor blockers), and there have been studies that have shown them to be most effective when taken at night before bedtime. Amlodipine can be taken at any time of the day, recommended to take at the same time every day,” Dr. Greene says.

One study from the European Heart Journal says taking medications in the evening can result in better daytime blood pressure control and reduce the risk of overnight cardiovascular events. A meta-analysis of randomized clinical trials from The American Heart Association agreed that evening administration is better for overnight blood pressure parameters and cardiovascular events but said the best time of day is one that’s “convenient, optimizes adherence, and minimizes undesirable effects.”

Per Dr. Greene, “If a patient is taking both of these medications, it is reasonable to take them both together at night before bedtime, or if desiring to take separately, taking the losartan at night and amlodipine in the morning.” But if you’re unsure, ask your healthcare provider. They’ll tailor your dosing schedule to your specific circumstances. The most important thing is to take your medications consistently, ideally at the same time every day, so choose a time that you won’t be likely to forget.

The bottom line

Not only are losartan and amlodipine safe to take together, they can treat hypertension more effectively than either one can alone. They work within the body in different ways, so neither gets in the way of the other, and this combination has helped many people manage their blood pressure. That doesn’t mean, however, that you should attempt it without first consulting a doctor. Only take these simultaneously when a doctor has prescribed it and provided a specific treatment plan.