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Drug vs. Drug

Lisinopril and amlodipine: Uses, side effects, and effectiveness

Lisinopril and amlodipine effectively lower blood pressure through different mechanisms and uses
Gerardo Sison medical writer headshot
By | Aug. 1, 2024
Two Rx tablets: Lisinopril vs. amlodipine

Key takeaways

  • Lisinopril and amlodipine treat high blood pressure; lisinopril also treats heart failure, while amlodipine treats certain types of chest pain.

  • Lisinopril is an ACE inhibitor, while amlodipine is a calcium channel blocker.

  • They can be prescribed together for improved blood pressure control.

  • Both drugs are available as generics and are typically covered by insurance and Medicare.

In this article:

Lisinopril and amlodipine are prescription medications commonly used to manage high blood pressure. Both drugs are available as brand-name and generic medications, making them accessible to many people. In addition, these medications are covered by most health insurance plans, including Medicare. Still, you might be wondering which one is better and what the differences are.

Lisinopril and amlodipine differ in various ways, including how they work, potential side effects, and uses approved by the U.S. Food and Drug Administration (FDA). Depending on a person’s medical condition, they may sometimes be prescribed together for improved blood pressure control. Therefore, it’s always important to consult a doctor or healthcare provider about treatment options.

What are the main differences between lisinopril and amlodipine?

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking the enzyme that converts angiotensin I to angiotensin II, which helps relax blood vessels and lower blood pressure. Lisinopril is generally taken as a daily oral tablet in a strength of 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, or 40 mg. Brand names include Prinivil and Zestril. 

Amlodipine is a dihydropyridine, a type of calcium channel blocker. It relaxes blood vessels by preventing calcium from entering the cells of the heart and blood vessel walls, which also leads to reduced blood pressure. Amlodipine is typically taken as a daily oral tablet in 2.5 mg, 5 mg, or 10 mg strength. Brand names include Norvasc and Katerzia. 

Both amlodipine and lisinopril result in a similar decrease in systolic and diastolic blood pressure in hypertensive patients.

Main differences between lisinopril and amlodipine
Lisinopril Amlodipine
Drug class ACE inhibitor Calcium channel blocker
Brand/generic status Brand and generic versions available Brand and generic versions available
What is the brand name? Prinivil, Zestril Norvasc, Katerzia, Norliqva
What form(s) does the drug come in? Oral tablet

Oral solution

 Oral tablet

Oral solution

Oral suspension
What is the standard dosage? 5 to 40 mg once daily in adults. 0.07 mg/kg (up to 5 mg) daily in children 5 to 10 mg once daily in adults. 2.5 to 5 mg once daily in children
How long is the typical treatment? Long-term Long-term
Who typically uses the medication? Adults and children 6 and older Adults and children 6 and older

Conditions treated by lisinopril and amlodipine

The FDA approves Lisinopril to treat high blood pressure in adults and children over six years old. It can also be used alongside other medications to treat heart failure. Lisinopril may also be prescribed after a heart attack to reduce the risk of death and future heart attacks or strokes.

The FDA also approved amlodipine to treat high blood pressure in adults and children over six. In addition, amlodipine can help people with certain types of chest pain caused by coronary artery disease. It can treat chronic stable angina, which is chest pain that occurs with physical activity or stress, and vasospastic angina due to spasms in the coronary arteries. Amlodipine may also be prescribed in people who are diagnosed with coronary artery disease but do not have heart failure or severely reduced heart function.

Condition Lisinopril Amlodipine
High blood pressure Yes Yes
Heart failure Yes No
Heart attacks Yes No
Chronic stable angina No Yes
Vasospastic angina No Yes

Is lisinopril or amlodipine more effective?

Lisinopril and amlodipine are both effective blood pressure-lowering drugs when compared to placebo. The more appropriate medication will depend on factors like overall medical condition and other medications being taken. In some cases, they may be taken together.

One study highlighted amlodipine‘s effectiveness in controlling high blood pressure. In a review of ASCOT and ALLHAT clinical trial patients, those treated with amlodipine had consistently lower blood pressure variability than those on medications like chlorthalidone or lisinopril, regardless of kidney function.

A double-blind study compared amlodipine and lisinopril alone and in combination. When used together, they lowered blood pressure more effectively than when used alone. Specifically, 71% of patients reached their target blood pressure with amlodipine and 72% with lisinopril, but the combination worked better even at lower doses.

Always consult a healthcare provider for the most effective antihypertensive therapy, especially if you have other conditions like heart disease and renal or kidney problems.

RELATED: How does lisinopril affect your kidneys?

Coverage and cost comparison of lisinopril vs. amlodipine

Lisinopril and amlodipine are widely available generic medications. They are typically covered by most insurance plans and Medicare Part D. Without insurance, the average price for a 30-day supply of 10 mg lisinopril tablets is around $40 versus around $62 for a 30-day supply of 10 mg amlodipine tablets. Still, the retail prices can vary based on pharmacy and location. 

Discount coupons like those offered by SingleCare may help make medications more affordable for those without insurance or with high copays. A SingleCare coupon for lisinopril and amlodipine may be used at participating pharmacies. 

Lisinopril Amlodipine
Typically covered by insurance? Yes Yes
Typically covered by Medicare Part D? Yes Yes
Quantity 10 mg (30 tablets) 10 mg (30 tablets)
Typical Medicare copay Varies Varies
SingleCare cost $2 $4

Common side effects of lisinopril vs. amlodipine

Lisinopril and amlodipine may have different side effects, though some can overlap. Lisinopril is known to cause a persistent dry cough, which can be bothersome for many people. Other frequent side effects of lisinopril include dizziness and headaches. While the side effects of amlodipine may also cause dizziness, other common side effects include fatigue, nausea, drowsiness, and swelling in the hands, legs, or feet (edema). 

Lisinopril Amlodipine
Side Effect Applicable? Frequency Applicable? Frequency
Headache Yes 4% No –
Dizziness Yes 4% Yes 3%
Cough Yes 3% No –
Flushing Yes >1% Yes 1%
Low blood pressure Yes 4% Yes N/A
Chest pain Yes 2% Yes 0.1-1%
Palpitations No – Yes 1%
Fatigue Yes >1% Yes 5%
Nausea No – Yes 3%
Drowsiness No – Yes 1%
Swelling in the hands, legs, or feet No – Yes 3%

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.

Source: DailyMed (Lisinopril), DailyMed (Amlodipine)

Drug interactions of lisinopril vs. amlodipine

Lisinopril and amlodipine may share similar interactions with other medications. For example, both medicines can interact with diuretics and other blood pressure medications, leading to an increased risk of low blood pressure. Taking lisinopril or amlodipine with PDE-5 inhibitors like sildenafil or tadalafil may also increase the risk of low blood pressure. 

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen may reduce the effectiveness of lisinopril and amlodipine. Taking NSAIDs with lisinopril may also increase the risk of kidney problems. 

Lisinopril can increase lithium levels in the blood, which can lead to lithium toxicity. Blood levels of lithium should be closely watched if taking both medications.

Drugs that affect the metabolism of amlodipine, like some antibiotics or antifungals, can increase or decrease amlodipine levels in the body, possibly leading to increased side effects or reduced effectiveness. Dose adjustments may be needed.

Amlodipine can increase the amount of simvastatin in the body, so the dose of simvastatin should be limited to 20 mg daily to avoid side effects.

Drug Drug Class Lisinopril Amlodipine
Lasix (furosemide)

Microzide (hydrochlorothiazide)

Aldactone (spironolactone)

 Diuretic Yes No
Advil (ibuprofen)

Aleve (naproxen)

Celebrex (celecoxib)

 NSAID Yes Yes
Eskalith (lithium) Mood stabilizer Yes No
Viagra (sildenafil)

Cialis (tadalafil)

Levitra (vardenafil)

 PDE-5 inhibitor Yes Yes
Afinitor (everolimus)

Rapamune (sirolimus)

Torisel (temsirolimus)

 mTOR inhibitor Yes Yes
Prograf (tacrolimus)

Sandimmune (cyclosporine)

 Calcineurin inhibitor Yes Yes
Glucophage (metformin)

Januvia (sitagliptin)

Amaryl (glimepiride)

 Antidiabetic agent Yes Yes
Zocor (simvastatin) Statin No Yes
Nizoral (ketoconazole)

Sporanox (itraconazole)

Diflucan (fluconazole)

 Antifungal No Yes
Ery-Tab (erythromycin)

Biaxin (clarithromycin)

 Antibiotic No Yes
Norvir (ritonavir)

Crixivan (indinavir)

Kaletra (lopinavir/ritonavir)

 Antiviral No Yes
Tegretol (carbamazepine)

Dilantin (phenytoin)

Luminal (phenobarbital)

 Anticonvulsant No Yes

Consult a healthcare professional for other possible drug interactions

Warnings of lisinopril and amlodipine

Both lisinopril and amlodipine can cause low blood pressure. It is especially important to monitor when starting these medications or increasing the dose. If you feel dizzy or faint, you should contact your doctor.

Lisinopril has several specific warnings. It can cause angioedema, which is swelling in deep layers of the skin, often around the eyes and lips. If this happens, you should stop taking lisinopril immediately and seek medical help. It can also affect kidney function, so regular monitoring of your kidneys is recommended, especially if you have kidney disease. 

Lisinopril may cause high levels of potassium in the blood (hyperkalemia), which can be dangerous. In addition, it can lead to liver problems like cholestatic jaundice and even liver failure. 

Amlodipine also has its own set of warnings. It may worsen chest pain (angina) or lead to a heart attack, particularly when first starting the medication or increasing the dose, especially in people with severe cardiovascular disease. If you have severe liver problems, you should start with a low dose of amlodipine and increase it slowly under your doctor’s guidance.

Consult a healthcare provider about other possible warnings and precautions before taking lisinopril or amlodipine.

Frequently asked questions about lisinopril vs. amlodipine

What is lisinopril?

Lisinopril is a medication commonly used to treat high blood pressure and heart failure. It belongs to a class of drugs called ACE inhibitors, which help relax blood vessels, making it easier for the heart to pump blood. Lisinopril can also improve survival after a heart attack.

What is amlodipine?

Amlodipine is a medication used to treat high blood pressure and chest pain (angina). It belongs to a class of drugs called calcium channel blockers, which help relax and widen blood vessels, making it easier for the heart to pump blood. This helps lower blood pressure and reduce the risk of heart-related problems. 

Are lisinopril and amlodipine the same?

No, they are not the same. Lisinopril is an ACE inhibitor, while amlodipine is a calcium channel blocker. They work in different ways and may be used for other purposes.

Is lisinopril or amlodipine better?

Lisinopril and amlodipine are both effective antihypertensive agents, but they work differently and may be better suited for different individuals. Lisinopril may be prescribed after a heart attack, while amlodipine may be prescribed for chest pain. In some cases, they may be used together for high blood pressure and related conditions. 

Can I use lisinopril or amlodipine while pregnant?

Lisinopril is generally not recommended during pregnancy, especially in the second and third trimesters, as it can harm a developing baby. Amlodipine‘s safety during pregnancy is less well-studied, so it’s important to consult a doctor. Always talk to a healthcare provider before taking any medication while pregnant to ensure the safety of both you and your baby.

Can I use lisinopril or amlodipine with alcohol?

Combining these antihypertensive drugs with alcohol can increase the risk of low blood pressure. As a result, combining them may lead to dizziness, fainting, or other side effects. It’s important to talk to a healthcare professional before drinking alcohol while on either medication.

Why do doctors prescribe amlodipine and lisinopril together?

Some people may not experience enough blood pressure control on amlodipine or lisinopril alone. Therefore, doctors may prescribe these medications together to control high blood pressure better, especially if you have other cardiovascular conditions like heart disease. 

Which is the safest blood pressure medication?

The safety of a medication depends on the dosage, a person’s overall health, and other medications being taken. Lisinopril and amlodipine are both considered safe when used as directed. Consult a healthcare provider to assess the risk factors before deciding on medication.