Lisinopril vs. Amlodipine
See how Lisinopril and Amlodipine compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both drugs are once-daily oral medications commonly used as first-line treatments for high blood pressure, but they work through different mechanisms and cause different side effects.
Lisinopril, an ACE inhibitor, is also approved for heart failure and improving survival after a heart attack, while amlodipine, a calcium channel blocker, is also approved for two types of angina.
Lisinopril's main tradeoffs are a persistent dry cough and effects on kidney function and potassium, while amlodipine's main tradeoff is swelling in the legs and ankles.
Lisinopril vs. Amlodipine Drug Summary
Lisinopril
Lisinopril is an ACE inhibitor that lowers blood pressure by blocking a hormone that narrows blood vessels. It treats hypertension, supports heart failure treatment, and improves survival after a heart attack. It comes as a tablet taken once a day, usually starting at 10 mg.
Amlodipine
Amlodipine is a calcium channel blocker that relaxes and widens blood vessels to lower blood pressure. It treats hypertension, chronic stable angina, and Prinzmetal's angina. It comes as a tablet taken once a day, usually starting at 2.5 mg.
Lisinopril vs. Amlodipine Side Effects
Lisinopril
Amlodipine
Lisinopril vs. Amlodipine Dosage
Lisinopril
Amlodipine
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | Up to 40 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| 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 |
Lisinopril
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | Up to 40 mg once daily | If needed |
| Dose changes | 3 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 |
Lisinopril vs. Amlodipine Indications
Lisinopril
Lisinopril is FDA-approved to treat high blood pressure in adults and children 6 and older. It's also approved as an add-on therapy for heart failure and to improve survival after a heart attack. Some doctors prescribe it off-label to help prevent migraines, though this isn't an FDA-approved use.
Hypertension in adults and children 6 and up
Adjunct treatment for heart failure
Improves survival after a heart attack
Off-label: sometimes used for migraine prevention
Amlodipine
Amlodipine is FDA-approved to treat high blood pressure in adults and children 6 and older. It's also approved for chronic stable angina, Prinzmetal's (vasospastic) angina, and coronary artery disease. It's commonly combined with other blood pressure medications when needed.
Hypertension in adults and children 6 and up
Chronic stable angina (exertional chest pain)
Vasospastic (Prinzmetal's) angina
Coronary artery disease
Lisinopril vs. Amlodipine Pros and Cons
Lisinopril
Lisinopril has decades of use in hypertension plus added FDA approvals for heart failure and post-heart-attack care that amlodipine doesn't have. It's a low-cost generic available at nearly every pharmacy. Cough and effects on kidney function and potassium are the main tradeoffs to watch for.
Pros
Also approved for heart failure and improving survival after a heart attack
Does not commonly cause the leg and ankle swelling that is amlodipine's top side effect
Long track record of pediatric hypertension dosing down to age 6
Cons
Can cause a persistent dry cough that sometimes doesn't resolve until stopped
Contraindicated in pregnancy due to risk of fetal harm
Requires monitoring of kidney function and potassium, especially with diuretics
Carries a rare but serious risk of angioedema (facial or throat swelling)
Amlodipine
Amlodipine's long half-life gives steady blood pressure control with a wide margin if a dose is missed. It's also FDA-approved for two forms of angina that lisinopril doesn't treat. Leg and ankle swelling is the main tradeoff many patients notice over time.
Pros
Also approved for chronic stable angina and Prinzmetal's (vasospastic) angina
No renal dose adjustment or kidney monitoring required
Does not cause cough or raise potassium levels
Cons
Swelling in the legs or ankles is common, affecting up to 10.8% of patients
Can worsen angina or trigger a heart attack shortly after starting or increasing the dose in severe coronary artery disease
Not approved for heart failure or post-heart-attack survival benefit like lisinopril
Requires caution in patients with severe aortic stenosis due to hypotension risk
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.