Lisinopril and amlodipine are both prescription medicines for high blood pressure, but they lower it in different ways. Lisinopril is an ACE inhibitor (angiotensin-converting enzyme inhibitor), and amlodipine is a calcium channel blocker. Neither one is better for everyone, because the right choice depends on your health history, your other medicines, and how your body responds.
If you take one of these medicines and are wondering why your doctor chose it, or whether you could take the other instead, the comparison below can help you ask better questions at your next visit.
Key takeaways
- Both medicines are widely used first-line treatments for hypertension (high blood pressure). The 2025 AHA/ACC guideline lists ACE inhibitors and long-acting calcium channel blockers among the usual first-choice drug classes (ACC).
- Their signature side effects differ. Lisinopril is linked to a dry cough, while amlodipine is linked to swelling in the ankles and feet, which becomes more common at higher doses (Norvasc label).
- Do not stop or switch either medicine on your own. Talk with your prescriber, and plan refills early so you do not run out.
What is the difference between lisinopril and amlodipine?
The main difference is how each medicine relaxes your blood vessels. Lisinopril blocks an enzyme your body uses to make angiotensin II, a hormone that narrows blood vessels, so blood flows more easily (MedlinePlus). Amlodipine blocks calcium from entering the muscle cells in blood vessel walls, which relaxes the vessels so the heart does not have to pump as hard (MedlinePlus).
Here is a side-by-side look at the general differences.
| Lisinopril | Amlodipine | |
|---|---|---|
| Drug class | ACE inhibitor | Calcium channel blocker |
| FDA-approved uses | High blood pressure, heart failure, and improving survival after a heart attack | High blood pressure, chronic stable and vasospastic angina, and coronary artery disease |
| Usual adult blood pressure dose | Starts at 10 mg once daily; usual range 20 to 40 mg | Starts at 5 mg once daily; maximum 10 mg |
| Signature side effect | Dry cough | Ankle and foot swelling |
| Pregnancy | Boxed warning for fetal toxicity; stop once pregnancy is detected | Human data are limited; discuss with your prescriber |
| Routine lab monitoring | Often potassium and kidney function | Usually none specific to the drug |
These are general points from the official labeling for lisinopril and amlodipine (Norvasc). Your own prescription label and your pharmacist can give you full details for your dose.
How common is high blood pressure?
High blood pressure is very common in the United States and often causes no symptoms at all. The CDC describes it as a major risk factor for heart disease and stroke, and the Mayo Clinic notes that regular readings are the only reliable way to know your numbers.
The 2025 guideline keeps a general goal of below 130/80 mm Hg for most adults and treats lifestyle changes as the foundation, with medicine added when needed (ACC). Because many people need more than one medicine to reach that goal, comparisons like this one come up often.
How do the side effects compare?
Side effects are often the reason people and prescribers compare these two medicines. Most are manageable, and a few need prompt attention.
Lisinopril side effects
In clinical trials for high blood pressure, headache, dizziness, and cough were each reported more often with lisinopril than with placebo. Cough occurred 2.5 percentage points more often than with placebo, according to the FDA label. The label also describes several serious concerns:
- Angioedema: Swelling of the face, lips, tongue, or throat that can make breathing difficult. It can happen at any time during treatment and needs emergency care. The label notes it is reported more often in Black patients.
- High potassium (hyperkalemia): Potassium can rise, especially with kidney problems, diabetes, potassium supplements, or salt substitutes that contain potassium.
- Fetal toxicity: The label carries a boxed warning and says to stop lisinopril as soon as pregnancy is detected.
If you are pregnant or planning to become pregnant, talk with your prescriber right away. For more on refilling this medicine, see our lisinopril page.
Amlodipine side effects
Swelling (edema) in the ankles, feet, or lower legs is the most common side effect of amlodipine, and it rises with the dose. In the Norvasc prescribing information, edema was reported in 10.8 percent of people taking 10 mg, 3.0 percent taking 5 mg, and 0.6 percent taking placebo. It was also reported more often in women than in men.
Other common side effects include dizziness, flushing, a fluttering or pounding heartbeat (palpitations), tiredness, and nausea. MedlinePlus advises getting care right away for more frequent or severe chest pain, a rapid or irregular heartbeat, or fainting (MedlinePlus).
Side effects can fade over time, but they can also signal that a dose needs adjusting. Report them to your prescriber rather than stopping the medicine on your own.
Which one is better for high blood pressure?
Neither is better for everyone. Research suggests several drug classes lower blood pressure effectively, and the large ALLHAT trial, which compared a thiazide-type diuretic, amlodipine, and lisinopril as first-step treatment, helped establish that more than one class is a reasonable starting point.
What matters most is the person taking the medicine. Prescribers weigh factors like these:
- Other conditions: Each label lists different approved uses, such as heart failure for lisinopril and angina for amlodipine, so related conditions can favor one class over another.
- Side effect history: A persistent cough on an ACE inhibitor, or troublesome swelling on amlodipine, may change the plan.
- Pregnancy plans: ACE inhibitors are not appropriate during pregnancy.
- Lab results: Potassium levels and kidney function can affect whether lisinopril is a good fit.
- Other medicines: Each drug has its own interactions, which your pharmacist can check.
Both medicines are available as generics, and both are usually taken once a day.
Can you take lisinopril and amlodipine together?
Yes, many people take both, and prescribers often combine them when one medicine is not enough. The American Heart Association describes combination therapy with more than one drug class as common for reaching a blood pressure goal (AHA).
The two classes work through different pathways, which is one reason they are often paired. The 2025 guideline also favors single-pill combinations in many cases to make daily dosing simpler (ACC). Only your prescriber can decide whether a combination is right for you.
Drug interactions to know about
Each medicine has interactions worth knowing, and your pharmacist can review your full list.
- Lisinopril and potassium: Potassium supplements, potassium-sparing diuretics, and potassium-based salt substitutes can raise potassium levels (DailyMed).
- Lisinopril and NSAIDs: Pain relievers such as ibuprofen and naproxen can affect kidney function and may blunt the blood pressure effect.
- Lisinopril and lithium: Lisinopril can raise lithium levels, so monitoring may be needed.
- Amlodipine and simvastatin: The Norvasc label says to limit simvastatin to 20 mg daily in people taking amlodipine (Norvasc label).
If you also take a cholesterol medicine, our comparison of simvastatin vs. atorvastatin explains how those two differ.
Can I switch from lisinopril to amlodipine, or the other way around?
Only your prescriber can make that decision. Switching changes how your blood pressure is controlled, and your dose, timing, and lab monitoring may need to change too.
Stopping a blood pressure medicine suddenly can allow your blood pressure to rise, and MedlinePlus advises not to stop amlodipine without talking to your doctor (MedlinePlus). If you are comparing other options, our article on lisinopril vs. losartan covers another common question.
What if I miss a dose?
The guidance is similar for both medicines. MedlinePlus says to take a missed lisinopril dose as soon as you remember, unless it is almost time for the next one (MedlinePlus). For amlodipine, it says to skip the missed dose if your next one is less than 12 hours away. In either case, do not take a double dose to catch up.
How does a refill work for stable blood pressure medicine?
MyMedRefills is an online prescription refill service for stable, chronic medications, including many blood pressure medicines. It fills a gap when you cannot get a timely appointment with your regular provider, and it is not a replacement for ongoing care. Here is how it works:
- Complete the online form. It takes about 5 minutes and requires a photo ID, photos of your medication bottles, and a selfie. No appointment is needed.
- A physician reviews your request. Review usually happens within a few hours.
- Your prescription goes to your pharmacy. It is sent electronically to the pharmacy you choose, usually the same day.
A board-certified physician decides whether each request is appropriate, and not every request is approved. The service is available in all 50 states, and you must be physically located in a state where the physician is licensed at the time of the request. Patients in Maryland, Louisiana, and Kentucky may receive a phone call or a video link. If you are stable on your blood pressure medicine and running low, you can request a refill online.
The service does not refill medications that need close monitoring, controlled substances, injectable medications, or lifestyle medications. Examples include opioids, benzodiazepines, muscle relaxers, antipsychotics, ADHD medications, weight loss medications, hormone replacement therapy, immunosuppressants including steroids, antibiotics, and antivirals. It also does not diagnose or treat new conditions.
If you have new symptoms, your readings are not controlled, or you want to discuss changing medicines, virtual primary care at HealthSource Medical Associates offers a full visit. Our hypertension page also covers refills for common blood pressure medicines.
When to seek medical attention
This is not an emergency service. In an emergency, call 911 or go to the nearest emergency room. Seek emergency care right away if you have chest pain, trouble breathing, swelling of the face, lips, tongue, or throat, fainting, weakness on one side of the body, or trouble speaking.
Contact your provider promptly if your readings stay high, you feel dizzy or lightheaded when you stand, your ankles swell noticeably, or a cough or other side effect is hard to tolerate.
Frequently asked questions
Is lisinopril or amlodipine safer? Both are considered safe for most people when used as prescribed, and each has its own risks. Lisinopril carries a pregnancy warning and a rare risk of angioedema, while amlodipine commonly causes ankle swelling. Your prescriber weighs these against your health history.
Can I take lisinopril and amlodipine at the same time of day? Many people do, since both are usually taken once daily. Follow your prescriber’s directions and your label, and ask your pharmacist if you are unsure about timing.
Which one causes a cough? Lisinopril is the one linked to a dry cough, which is a recognized effect of ACE inhibitors. If a cough bothers you, tell your prescriber instead of stopping the medicine.
Which one causes ankle swelling? Amlodipine is the one more commonly linked to swelling in the ankles, feet, or lower legs, and it is more likely at higher doses. Report new or worsening swelling to your provider.
Is amlodipine stronger than lisinopril? There is no simple ranking, because the two work differently and are dosed differently. Both can lower blood pressure effectively, and the better fit depends on your health history and how you respond.
Can I get a refill online if I am about to run out? If you are stable on your medicine and it is not on the excluded list, a physician can review an online refill request. Eligibility depends on that review, and not every request is approved.
Next steps
If you are stable on your blood pressure medicine and cannot reach your regular provider before you run out, a board-certified physician can review your refill request. MyMedRefills sends eligible prescriptions to your preferred pharmacy, usually the same day, and a 12-month refill option is available through a short video visit. Current pricing is listed on the request page, where you can get a prescription refill. Keep your regular provider involved for ongoing blood pressure care.
Sources
- DailyMed, Lisinopril tablets prescribing information (FDA label)
- Pfizer, Norvasc (amlodipine besylate) prescribing information
- MedlinePlus, Lisinopril
- MedlinePlus, Amlodipine
- American College of Cardiology, 2025 AHA/ACC high blood pressure guideline summary
- ALLHAT Officers and Coordinators, JAMA 2002 (PubMed)
- American Heart Association, Types of blood pressure medications
- CDC, High Blood Pressure
- Mayo Clinic, High blood pressure (hypertension)
- Mayo Clinic, High blood pressure medications
This article is for informational purposes only and is not a substitute for professional medical advice.