Amlodipine vs. Losartan
See how Amlodipine and Losartan compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Amlodipine and losartan both treat high blood pressure, but one blocks calcium channels and the other blocks an angiotensin hormone receptor.
Doctors often combine amlodipine and losartan, sometimes in a single pill, when one drug alone does not fully control blood pressure.
Both are taken once daily for most patients, and both have generic versions that are widely available and inexpensive.
Amlodipine vs. Losartan Drug Summary
Amlodipine
Amlodipine is a dihydropyridine calcium channel blocker used to treat high blood pressure, chronic stable angina, and vasospastic angina. It works by relaxing blood vessel walls so the heart pumps against less resistance. It comes as a tablet taken once a day, with or without food.
Losartan
Losartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure and to protect the kidneys in people with type 2 diabetes. It works by blocking a hormone that narrows blood vessels. It comes as a tablet, usually taken once a day starting at 50 mg.
Amlodipine vs. Losartan Side Effects
Amlodipine
Losartan
Amlodipine vs. Losartan Dosage
Amlodipine
Losartan
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 100 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Amlodipine
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Losartan
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg once daily | At the start |
| Maximum dose | 100 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Amlodipine vs. Losartan Indications
Amlodipine
Amlodipine is FDA-approved to treat high blood pressure, chronic stable angina, and vasospastic (Prinzmetal's) angina. It relaxes blood vessel walls, which lowers blood pressure and reduces how hard the heart has to work. It is also used in coronary artery disease to help prevent chest pain episodes.
Hypertension (high blood pressure)
Chronic stable angina
Vasospastic (Prinzmetal's) angina
Losartan
Losartan is FDA-approved to treat high blood pressure and to reduce the risk of stroke in people with hypertension and left ventricular hypertrophy. It is also approved to slow kidney damage in people with type 2 diabetes who have high blood pressure. It works by blocking a hormone that narrows blood vessels.
Hypertension (high blood pressure)
Stroke risk reduction with left ventricular hypertrophy
Diabetic nephropathy in type 2 diabetes
Amlodipine vs. Losartan Pros and Cons
Amlodipine
Amlodipine has a long half-life, so blood pressure control stays steady even if a dose is taken a few hours late. It needs no dose adjustment for kidney problems, and it has extra FDA approvals for two types of chest pain that losartan does not cover.
Pros
Long half-life keeps blood pressure steady even with a slightly missed dose
No dose adjustment needed for kidney problems
Also approved for chronic stable angina and vasospastic angina
Simple once-daily dosing with just one titration step
Cons
Swelling in the legs or ankles (edema) is common and dose-related
Stopping it abruptly can worsen chest pain in severe coronary artery disease
Titration must be slower in people with severe liver disease
Flushing and palpitations can occur, especially at higher doses
Losartan
Losartan blocks the angiotensin hormone instead of calcium channels, making it a common alternative for people who cannot tolerate ACE inhibitors because of cough. It needs periodic blood tests to check kidney function and potassium, and it carries an added kidney-protective approval for diabetes.
Pros
Extra FDA approval to slow kidney damage in type 2 diabetes with hypertension
Approved to lower stroke risk in hypertension with left ventricular hypertrophy
Rarely causes the dry cough associated with ACE inhibitors
Does not cause the leg swelling seen with calcium channel blockers
Cons
Requires periodic blood tests for kidney function and potassium levels
Cannot be used during pregnancy due to risk of fetal harm
Interacts with NSAIDs and potassium-raising drugs
May need a dose increase to 100 mg if 50 mg does not fully control blood pressure
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