Can I take amlodipine and olmesartan together? The Combination Approach for Hypertension

October 8, 2025 •

4 min read

According to clinical studies, using a combination of two different classes of antihypertensive agents, like amlodipine and olmesartan, can be significantly more effective at lowering blood pressure than monotherapy. This powerful approach combines two different mechanisms to provide robust and sustained blood pressure control.

Quick Summary

Amlodipine and olmesartan are frequently prescribed together, often in a single tablet known as Azor, to treat high blood pressure. This combination therapy leverages two distinct mechanisms of action to achieve greater blood pressure reduction and improve patient outcomes compared to taking either medication alone.

Key Points

Combination Approved: Amlodipine and olmesartan are commonly prescribed together, often as a fixed-dose combination pill (Azor), for high blood pressure.
Dual Action: Amlodipine is a calcium channel blocker, and olmesartan is an angiotensin II receptor blocker, using two distinct mechanisms to lower blood pressure more effectively.
Enhanced Efficacy: Combining the two drugs provides a greater reduction in blood pressure compared to using either drug alone, helping more patients reach their target goals.
Reduced Edema: The addition of olmesartan helps counteract the peripheral edema (swelling) that is a common side effect of amlodipine, improving tolerability.
Fetal Risk: This combination is strictly contraindicated during pregnancy, as it can cause serious harm or death to the fetus.
Potassium Monitoring: The olmesartan component can cause an increase in potassium levels, especially when combined with potassium supplements or certain other medications, requiring regular monitoring.
Sprue-like Enteropathy: In rare cases, the olmesartan component may cause severe, chronic diarrhea with weight loss, which must be reported to a doctor immediately.

How Amlodipine and Olmesartan Work Together

Amlodipine and olmesartan belong to different classes of medication, allowing them to work together synergistically to lower blood pressure. This dual mechanism of action targets two different pathways that contribute to hypertension.

Amlodipine: A Calcium Channel Blocker

Amlodipine is a dihydropyridine calcium channel blocker (CCB). It works by affecting the movement of calcium into the cells of the heart and blood vessels. This action causes the blood vessels to relax and widen, which lowers blood pressure and reduces the workload on the heart. Amlodipine has a slow onset and a long half-life, making it effective for once-daily dosing. However, a common side effect is peripheral edema (swelling of the ankles and feet) due to vasodilation.

Olmesartan: An Angiotensin II Receptor Blocker (ARB)

Olmesartan is an angiotensin II receptor blocker (ARB). It lowers blood pressure by blocking the effect of angiotensin II, a hormone that causes blood vessels to constrict and narrow. By blocking this hormone, olmesartan relaxes blood vessels and reduces blood pressure. As a bonus, olmesartan also counteracts some of the adverse effects of CCBs.

The Synergistic Effect

When taken together, the combined action provides more effective blood pressure reduction than either drug alone. Amlodipine's vessel-relaxing effect is enhanced, while olmesartan's blocking of the renin-angiotensin-aldosterone system helps mitigate the peripheral edema associated with amlodipine. This leads to better patient tolerability and compliance, as the side effects are less pronounced.

The Benefits of Combining Amlodipine and Olmesartan

Combination therapy offers several advantages for patients with hypertension, particularly those who have not achieved adequate blood pressure control with a single medication.

Enhanced Blood Pressure Reduction: The combination of two different mechanisms of action results in a greater overall reduction in blood pressure. Clinical studies have shown that patients on combination therapy achieve target blood pressure goals more effectively than those on monotherapy.

Reduced Side Effects: The addition of an ARB like olmesartan can significantly decrease the incidence of peripheral edema, a common side effect of amlodipine monotherapy. This improves the patient's quality of life and encourages them to continue their treatment as prescribed.

Convenience and Compliance: This medication is available as a single fixed-dose combination tablet (brand name Azor). Taking a single pill instead of two separate ones can simplify the daily medication regimen and improve patient adherence, leading to more consistent blood pressure control.

Organ Protection: Beyond just lowering blood pressure, studies have shown that the components of this combination can offer additional protective benefits for organs, such as improving vascular health and function.

Comparison: Combination vs. Individual Monotherapy


Feature	Amlodipine Monotherapy	Olmesartan Monotherapy	Amlodipine/Olmesartan Combination	Benefits of Combination
Mechanism	Calcium Channel Blocker (CCB)	Angiotensin II Receptor Blocker (ARB)	CCB + ARB	Synergistic and more effective action
Efficacy	Effective for some, but may not be enough for moderate-to-severe hypertension.	Effective for some, but many will require a second agent.	Significantly more effective, reaching target goals for more patients.	Stronger blood pressure reduction
Side Effect: Edema	Common, dose-dependent side effect, especially at higher doses.	Not a common side effect.	Reduced incidence of edema, even at higher doses of amlodipine.	Improves tolerability
Pill Burden	One pill daily.	One pill daily.	Often one pill daily (e.g., Azor).	Maintains low pill burden for enhanced effect
Dosage Adjustment	Can be adjusted based on needs.	Can be adjusted based on needs.	Fixed-dose tablets simplify dosing; adjusted by changing strength.	Simplifies regimen

Important Considerations and Warnings

It is critical to discuss all health conditions with your doctor before starting this medication. Certain medical conditions and concurrent drug use require caution.

**Contraindications:

Pregnancy: Amlodipine and olmesartan can cause harm or even death to an unborn baby, especially when taken during the second and third trimesters. The medication should be discontinued as soon as pregnancy is detected.
Diabetes and Aliskiren: Patients with diabetes should not take this combination with medications containing aliskiren.

**Drug Interactions:

Potassium Supplements: Using potassium-containing salt substitutes or supplements can cause high potassium levels (hyperkalemia). This should be discussed with your doctor.
NSAIDs: Non-steroidal anti-inflammatory drugs can increase the risk of renal impairment and reduce the antihypertensive effect.
Lithium: Concomitant use can increase serum lithium levels and toxicity.

**Special Populations:

Severe Renal Impairment: Not recommended for patients with severe kidney problems.
Hepatic Impairment: Requires caution in patients with liver problems, as clearance of amlodipine may be decreased.

Conclusion

Yes, it is common and often beneficial to take amlodipine and olmesartan together for the treatment of high blood pressure. The combination, available in generic and brand-name forms like Azor, offers a robust and effective strategy for many patients who do not achieve adequate blood pressure control with a single medication. By combining two distinct mechanisms of action, it provides superior blood pressure reduction while also mitigating certain side effects associated with monotherapy, such as edema. As with any prescription medication, it is essential to consult with a healthcare professional to ensure this is the right treatment for your individual health needs and to follow their dosage and monitoring instructions carefully. For more in-depth clinical details, refer to resources like the U.S. FDA's DailyMed database.

What to Expect on Amlodipine/Olmesartan Treatment

To ensure safe and effective use, patients should be aware of a few key aspects of this therapy:

Regular Monitoring: Your doctor will periodically check your blood pressure, kidney function, and electrolytes, especially potassium levels.
Dizziness and Lightheadedness: Be cautious when standing up or operating machinery, especially when first starting or adjusting the dose, as dizziness may occur.
Hydration: Stay well-hydrated. Excessive sweating, vomiting, or diarrhea can cause dehydration and a drop in blood pressure.
Severe Diarrhea: While rare, severe, chronic diarrhea with weight loss (sprue-like enteropathy) can occur months to years after starting olmesartan. Report this to your doctor immediately.

Always follow your doctor's instructions and never stop or change your medication without their guidance.

Frequently Asked Questions

The brand name for the combination of amlodipine and olmesartan is Azor. It is also available as a generic medication.

The combination offers superior blood pressure reduction by targeting two different mechanisms. It also reduces the incidence of peripheral edema, a common side effect of amlodipine monotherapy.

No, you should not stop taking this medication suddenly without consulting your doctor. High blood pressure often has no symptoms, and stopping the medication can cause a dangerous spike in blood pressure.

Common side effects include dizziness, fatigue, headache, and swelling in the hands or feet (edema). These side effects may decrease as your body adjusts to the medication.

In rare cases, olmesartan can cause a severe, chronic form of diarrhea called sprue-like enteropathy, which may result in weight loss. You should report persistent diarrhea to your doctor immediately.

No, this combination is not safe during pregnancy, especially during the second and third trimesters. The olmesartan component can cause serious harm or death to the fetus.

You should take your medication once daily, at the same time each day, as directed by your doctor. It can be taken with or without food.