Amlodipine and losartan side effects

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Side Effects of Amlodipine and Losartan: A Comparative Analysis

Introduction to Amlodipine and Losartan

Amlodipine and losartan are commonly prescribed medications for managing hypertension. Amlodipine is a calcium channel blocker, while losartan is an angiotensin II receptor blocker (ARB). Both drugs are effective in lowering blood pressure, but they have different mechanisms of action and side effect profiles.

Common Side Effects of Amlodipine

Edema and Swollen Ankles

One of the most frequently reported side effects of amlodipine is peripheral edema, particularly swollen ankles. This side effect was significantly more common in patients treated with amlodipine compared to those treated with losartan 4510. The incidence of swollen ankles was notably higher in the amlodipine group, affecting up to 10% of patients .

Dizziness and Hypotension

Amlodipine can also cause dizziness, particularly when standing up quickly. This side effect is less common but still noteworthy. In comparative studies, dizziness was reported more frequently in patients taking amlodipine than in those taking losartan .

Other Side Effects

Other side effects of amlodipine include headaches, flushing, and palpitations. These are generally mild but can be bothersome for some patients .

Common Side Effects of Losartan

Dizziness and Orthostatic Hypotension

Losartan can cause dizziness, particularly when standing up quickly, similar to amlodipine. However, this side effect is generally less common in losartan-treated patients compared to those on amlodipine 45.

Renal Effects

Losartan has been shown to have beneficial effects on renal function, particularly in patients with diabetic nephropathy or chronic kidney disease. However, it can also cause changes in renal hemodynamics, which may lead to increased serum creatinine levels in some patients 123.

Other Side Effects

Other side effects of losartan include fatigue, nasal congestion, and back pain. These are generally mild and less frequent compared to the side effects associated with amlodipine .

Comparative Tolerability

Withdrawal Rates and Adverse Events

Studies have shown that the incidence of drug-related adverse events and the number of patients withdrawn from therapy were higher with amlodipine than with losartan 45. This suggests that losartan may be better tolerated overall.

Quality of Life

In terms of quality of life, patients treated with losartan reported fewer side effects and better overall well-being compared to those treated with amlodipine . This was assessed using the Psychological General Well-Being (PGWB) index, which showed improvements in some domains for the losartan groups, whereas it remained unchanged for the amlodipine group .

Conclusion

Both amlodipine and losartan are effective antihypertensive agents, but they have different side effect profiles. Amlodipine is more likely to cause peripheral edema and dizziness, while losartan is associated with fewer adverse events and better overall tolerability. When choosing between these medications, healthcare providers should consider the side effect profiles and individual patient needs to optimize treatment outcomes.

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Most relevant research papers on this topic

Effects of losartan and amlodipine on urinary albumin excretion and ambulatory blood pressure in hypertensive type 2 diabetic patients with overt nephropathy.

In type 2 diabetes with overt nephropathy, 24-hour blood pressure regulation alone is inadequate to reduce macroalbuminuria, and additional effects of losartan are crucial for antiproteinuric action.

RCTRigorous Journal

2005·

31citations

·G. Yasuda et al.

Renal effects of losartan and amlodipine in hypertensive patients with non-diabetic nephropathy.

Losartan, but not amlodipine, decreased albumin excretion in hypertensive patients with non-diabetic nephropathy.

RCT

1998·

68citations

·H. Holdaas et al.

Renoprotective effect of losartan in comparison to amlodipine in patients with chronic kidney disease and hypertension--a report of the Japanese Losartan Therapy Intended for the Global Renal Protection in Hypertensive Patients (JLIGHT) study.

Losartan reduces proteinuria in patients with chronic kidney disease and hypertension, potentially contributing to its renal protective benefit beyond blood pressure control.

RCTHighly Cited

2004·

79citations

·Y. Iino et al.

Main results of the losartan versus amlodipine (LOA) study on drug tolerability and psychological general well‐being

Losartan and amlodipine effectively lower blood pressure, but amlodipine has higher drug-related adverse effects and withdrawal rates.

RCTLarge Human Trial

1997·

57citations

·B. Dahlöf et al.

Prospective and randomized study of the antihypertensive effect and tolerability of three antihypertensive agents, losartan, amlodipine, and lisinopril, in hypertensive patients

Losartan has the same antihypertensive effect as amlodipine and lisinopril, but has superior tolerability, with coughing being a common side effect of lisinopril therapy.

RCT

2003·

20citations

·San‐Chiang Wu et al.

Comparisons of the pharmacokinetics and tolerability of fixed-dose combinations of amlodipine besylate/losartan and amlodipine camsylate/losartan in healthy subjects: a randomized, open-label, single-dose, two-period, two-sequence crossover study

An FDC of 6.94 mg amlodipine besylate/5 mg losartan potassium is similar to an FDC of 5 mg amlodipine camsylate/5 mg losartan potassium in pharmacokinetics and tolerability in healthy male subjects.

RCTRigorous Journal

2016·

11citations

·Yoonjung Choi et al.

Efficacy and safety of losartan in children with Alport syndrome--results from a subgroup analysis of a prospective, randomized, placebo- or amlodipine-controlled trial.

Losartan significantly reduced proteinuria and was well-tolerated after 12 weeks of treatment in children aged 1-17 years with Alport syndrome and proteinuria, regardless of hypertension.

RCT

2011·

46citations

·N. Webb et al.

Effects of losartan and amlodipine on intrarenal hemodynamics and TGF-beta(1) plasma levels in a crossover trial in renal transplant recipients.

Losartan maintains renal function and reduces TGF-beta1 levels, while amlodipine increases GFR and has opposite effects, potentially impacting chronic allograft nephropathy management.

RCTHighly Cited

2001·

116citations

·P. Iñigo et al.

Pharmacokinetic and haemodynamic interactions between amlodipine and losartan in human beings

Co-administration of amlodipine and losartan is tolerable and does not cause substantial pharmacokinetic interaction, but combination use causes additive haemodynamic changes compared to either drug alone.

2019·

10citations

·Jin-Woo Park et al.

Efficacy, safety, and effects on hypertension-associated symptoms of losartan, alone or in combination with hydrochlorothiazide, versus amlodipine in patients with mild-to-moderate hypertension

Losartan is as effective as amlodipine for reducing blood pressure in patients with mild-to-moderate hypertension, but has fewer drug-related side effects.

RCTLarge Human Trial

1998·

9citations

·R. Tiebel et al.

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