Minor
Established
Description
The combination of amlodipine and lisinopril provides complementary antihypertensive mechanisms and may cause additive hypotension, particularly with initial dosing.
Mechanism
Amlodipine produces arteriolar vasodilation via L-type calcium channel blockade; lisinopril reduces angiotensin II–mediated vasoconstriction. Together they produce additive blood pressure reduction.
Clinical Significance
The combination is guideline-recommended for hypertension management and generally well tolerated; first-dose hypotension, dizziness, and syncope are the primary concerns.
Management
Start with low doses and titrate gradually; counsel patients about orthostatic hypotension, particularly in elderly patients.