Amlodipine is a widely recommended drug and the most frequently administered high blood pressure (BP) medication. When people are identified with high blood pressure and a drug is prescribed, amlodipine is sometimes the first option.
Any medication can have adverse effects, and amlodipine is no exception. Patients may be offered an Amlodipine alternative medicine in the future. According to the suggested therapy recommendations, we will explore alternatives to amlodipine. An essential lesson to remember is that the choice of alternative amlodipine will be influenced by national blood pressure guidelines, which explicitly indicate recommended treatment for various patient groups.
Amlodipine is classified as a calcium channel blocker (CCB). As the name suggests, amlodipine stops calcium movement into cells in blood vessels, the heart, and the pancreas. Calcium is responsible for smooth muscle contractions. Consequently, amlodipine causes the dilation of blood vessels, which helps to decrease blood pressure.
Is Amlodipine A Beta-Blocker?
No, amlodipine is not a beta-blocker. It belongs to a family of medications called calcium channel blockers. Beta-blockers, on the other hand, act by inhibiting the effects of the hormone epinephrine (commonly known as adrenaline) on the body’s beta receptors. Amlodipine relaxes the blood arteries, decreasing blood pressure and increasing blood flow.
Why Is Amlodipine Most Popular Blood Pressure Drug?
Amlodipine was the second most commonly prescribed medication in the United States in 2020, with over 87 million prescriptions filled. This makes it one of the most popular drugs, not just for high blood pressure. Its popularity can be attributed to its effectiveness in lowering blood pressure, it’s once-daily dosing, and its relatively low cost compared to other blood pressure medications.
Additionally, amlodipine has been on the market for over 30 years and has a proven Safety record, which has helped to establish its place as a first-line treatment for hypertension.
High blood pressure incidence rises with age; for example, in England, 58% of men and women aged 65 to 74 have high blood pressure. This helps to clarify why amlodipine is so prevalent.
If therapy does not yield acceptable results or patients experience adverse effects, the high blood pressure medicine is altered or given an extra drug.
Can You Replace Amlodipine With Lifestyle Changes?
This article primarily centers on amlodipine alternatives. Typically, patients are counseled by their doctor about lifestyle factors that may add to elevated blood pressure.
The topic of lifestyle and its effect on blood pressure merits debate. However, the topic’s significance should be discussed. Blood pressure is greatly affected by lifestyle changes, food, and exercise. Physical activity is a crucial component of lifestyle adjustments. A mountain of data demonstrates exercise’s benefits in preventing and managing hypertension.
Physical activity lowers both systolic and diastolic blood pressure. Furthermore, exercise reduces blood pressure immediately, with the impact continuing for more than 24 hours. Regular exercise helps to maintain a steady drop in blood pressure.
List of Amlodipine Alternatives
| Drug name | Uses | Dosage | Side Efffects |
|---|---|---|---|
| Indapamide |
| 1.25 to 5 mg once daily, Your doctor may adjust your dose if needed. |
|
| Chlorthalidone |
| At first, 25 milligrams (mg) once a day, Your doctor may adjust your dose if needed. |
|
| Bendroflumethiazide |
| 5 to 20 mg orally once a day, Your doctor may adjust your dose if needed. |
|
| Ramipril |
| 2.5 milligrams (mg) once a day, Your doctor may adjust your dose if needed. |
|
| Lisinopril |
| 10 milligrams (mg) once a day, Your doctor may adjust your dose if needed. |
|
| Enalapril |
| 2.5 milligrams (mg) two times a day, Your doctor may adjust your dose if needed. |
|
| Losartan |
| 50 milligrams (mg) once a day, Your doctor may adjust your dose if needed. |
|
| Candesartan |
| 16 milligrams (mg) once a day, Your doctor may adjust your dose if needed. |
|
Amlodipine Alternative: Diuretics Drugs
When amlodipine is not accepted, for example, due to edema, diuretics (thiazide-type) are given to patients over 55 or patients of Caribbean or African descent (no diabetes). Diuretics, also called ‘water tablets,’ boost urine production. Increased water loss from the body lowers blood volume, lowering blood pressure.
1. Indapamide
Indapamide is a diuretic medication sometimes used as an alternative to amlodipine, a calcium channel blocker. Both medicines are used to treat high blood pressure (hypertension).
Indapamide works by increasing the amount of urine produced by the kidneys, which helps to lower blood pressure. Amlodipine works by relaxing the blood vessels, which also helps to lower blood pressure.
2. Chlorthalidone
Chlorthalidone is a diuretic medication for high blood pressure (hypertension). It works by increasing the amount of urine produced by the kidneys, which helps to remove excess fluid from the body and lower blood pressure.
In clinical studies, chlorthalidone is an effective treatment for hypertension. It is often recommended as a first-line treatment for high blood pressure, alone or in combination with other medications.
Chlorthalidone is generally well-tolerated but can cause side effects like all medications. Common side effects include dizziness, headache, and muscle cramps. Rare but severe side effects can consist of electrolyte imbalances, which can cause symptoms such as muscle weakness, confusion, and irregular heartbeat.
It’s essential to work with a healthcare provider to determine the best treatment plan for hypertension, including using chlorthalidone or other medications. Your provider can help monitor your blood pressure and adjust your medicines for optimal blood pressure control.
3. Bendroflumethiazide
Bendroflumethiazide is a type of medication known as a thiazide diuretic. It is commonly used to treat high blood pressure (hypertension) by reducing the amount of water in the body, thus lowering blood pressure. This medication works by increasing urine production, which helps remove excess fluid and salt from the body.
Bendroflumethiazide is often used as a first-line treatment for hypertension and may be prescribed alone or in combination with other medications. It can cause side effects such as dizziness, headaches, and muscle cramps. In rare cases, it can cause more severe side effects like electrolyte imbalances, which can cause symptoms such as muscle weakness and irregular heartbeat.
If you have been prescribed bendroflumethiazide, it is essential to follow your healthcare provider’s instructions closely and report any side effects or concerns promptly.
Amlodipine Alternative: ACE Inhibitors
ACE inhibitors are a class of medication that can be used as an alternative to amlodipine to treat high blood pressure. ACE inhibitors work by relaxing blood vessels, which helps to lower blood pressure.
Some examples of ACE inhibitors include lisinopril, enalapril, and ramipril. Like all medications, ACE inhibitors can cause side effects, such as coughing, dizziness, and headache.
How Do ACE-Inhibitors Reduce Blood Pressure?
The choice of medication to treat high blood pressure depends on several factors, including the individual’s blood pressure readings, medical history, and any other medicines they take. It’s essential to work with a healthcare provider to determine the best treatment plan for hypertension, including using amlodipine or alternative medications like ACE inhibitors.
4. Ramipril
Ramipril also comes in the most commonly prescribed drugs, ACE inhibitors for blood pressure and the second most widely administered high blood pressure drug.
There are no particular guidelines for prescribing ramipril as a first-line treatment for high blood pressure. For individuals who have had a heart attack or have heart failure, ramipril, lisinopril, and perindopril may be recommended. (NICE, 2020). Ramipril is available in pills and granules. The dosage of ramipril ranges from 1.25mg to 10mg.
5. Lisinopril
Lisinopril is a medication that belongs to a class of drugs called ACE inhibitors. It can be used as an alternative to amlodipine to treat high blood pressure (hypertension). Lisinopril works by relaxing blood vessels, which helps to lower blood pressure.
Unlike amlodipine, a calcium channel blocker, lisinopril does not affect the movement of calcium in the body. Instead, it blocks the activity of an enzyme that causes blood vessels to be narrow.
Lisinopril is generally well-tolerated but can cause side effects like all medications. Common side effects of lisinopril include coughing, dizziness, headache, and fatigue. Rarely, lisinopril can cause more severe side effects, such as allergic reactions, kidney problems, or low blood pressure.
The choice of medication to treat high blood pressure depends on several factors, including the individual’s blood pressure readings, medical history, and any other medicines they take.
6. Enalapril
Enalapril is a medication that belongs to a class of drugs called ACE inhibitors. It can be used as an alternative to amlodipine to treat high blood pressure (hypertension). Enalapril works by blocking the activity of an enzyme that causes blood vessels to be narrow, which helps to relax blood vessels and lower blood pressure.
Enalapril is generally well-tolerated but can cause side effects like all medications. Common side effects of enalapril include coughing, dizziness, headache, and fatigue. Rarely, enalapril can cause more severe side effects, such as allergic reactions, kidney problems, or low blood pressure.
Angiotensin II Receptor Antagonists As Amlodipine Alternatives:
Angiotensin II receptor antagonists, also known as ARBs, are a class of medications that can be used as alternatives to amlodipine to treat high blood pressure. ARBs inhibit the activity of angiotensin II, a hormone that causes blood vessels to constrict and raises blood pressure.
Like amlodipine, ARBs are effective at lowering blood pressure and reducing the risk of cardiovascular events. They are generally well-tolerated but can cause side effects like all medications. Common side effects of ARBs include dizziness, headache, and fatigue. Rarely, ARBs can cause more severe side effects, such as allergic reactions, kidney problems, or low blood pressure.
Unlike ACE inhibitors, angiotensin II receptor blockers do not cause cough or edema.
The most common angiotensin II receptor blockers used are:
- Losartan
- Candesartan
Angiotensin II Receptor Blockers: Common Side Effects
- Dizziness
- Vertigo
- Hyperkalaemia (low level of potassium)
- Abdominal pain, nausea, and vomiting
- Headaches
- Postural hypotension (drop in blood pressure when standing up)
Can Angiotensin II Receptor Antagonists Be Alternative For Amlodipine?
We are examining the high blood pressure control recommendations. ACE medications can be replaced with angiotensin II receptor blockers. (ramipril).
When initiating the treatment, in particular to patients who:
- Have diabetes of any age or family origin
- They are under 55 years of age but not of black African or African–Caribbean family origin
7. Losartan
Losartan is a medication that belongs to a class of drugs known as angiotensin II receptor blockers (ARBs). It is commonly used to treat high blood pressure (hypertension) and other cardiovascular conditions.
Losartan works by blocking the action of a hormone called angiotensin II, which causes blood vessels to be narrow and can increase blood pressure. By blocking this hormone, losartan relaxes blood vessels and reduces blood pressure. It is also thought to have protective effects on the heart and kidneys.
Like all medications, losartan can cause side effects. Common side effects include dizziness, headache, and fatigue. Rarely, losartan can cause more severe side effects, such as allergic reactions, kidney problems, or low blood pressure.
It is the most commonly prescribed angiotensin II receptor blocker, with over ten mln prescriptions issued in the last 12 months (OpenPrescribing.net, 2021).
8. Candesartan,
Candesartan is a medication that belongs to a class of drugs known as angiotensin II receptor blockers (ARBs). It is commonly used to treat high blood pressure (hypertension) and other cardiovascular conditions.
Candesartan works by blocking the action of a hormone called angiotensin II, which causes blood vessels to be narrow and can increase blood pressure. By blocking this hormone, candesartan relaxes blood vessels and reduces blood pressure. It is also thought to have protective effects on the heart and kidneys.
The efficacy of the second most commonly prescribed angiotensin II receptor blocker does not vary from that of losartan. There is inadequate data to demonstrate that one angiotensin II receptor blocker is more successful than others in lowering blood pressure.
Final Words From AZdrug
The above list was finished by STAGE 1 of blood pressure control (initiation of therapy). Other blood pressure therapy uses two, three, or even four drugs.
At STAGE 2, for example, a calcium channel blocker (amlodipine) and an ACE inhibitor (ramipril) or angiotensin II receptor blocker (losartan) or diuretic could be used. STAGE 3 patients are treated with three different medications, while STAGE 4 patients are treated with four antihypertensive drugs.
We have enumerated the most commonly used antihypertensive medications, regarded as first-line therapy for high blood pressure. Although this article aimed to provide a list of alternative amlodipine drugs, it is evident that choosing alternative amlodipine medications depends on individual patients and any other underlying conditions they may have.