Can I take Amlodipine and Ramipril together?

Why this happens

Both medicines work to lower blood pressure but in different ways. Amlodipine relaxes your blood vessels, while ramipril blocks a hormone that narrows them. When used together, their effects add up (an additive effect), which is often a deliberate choice by doctors to manage high blood pressure more effectively.

What you should do

This is a very common and helpful combination, but you should be careful when first starting them or when your dose is increased. To avoid dizziness, get up slowly from a sitting or lying position. Your doctor will likely perform regular blood tests to check your kidney function and potassium levels. If you feel very dizzy or notice your heart racing, contact your GP.

Important precautions

Pregnancy

You must not take ramipril if you are pregnant or planning to become pregnant, as it can cause serious harm or death to an unborn baby. Use effective contraception while taking this medicine.

Angioedema (Severe Swelling) - ramipril

Seek emergency medical help immediately if you experience swelling of the face, lips, tongue, or throat, or difficulty breathing. This is a rare but life-threatening allergic reaction.

Dizziness and Fainting (First-dose effect)

These medicines can cause a sharp drop in blood pressure, especially after the very first dose of ramipril. Take your first dose at bedtime to avoid dizziness or fainting.

Food and drink warnings

Grapefruit juice

Grapefruit juice can increase the amount of amlodipine in your blood, which may cause your blood pressure to drop too low and increase the risk of side effects like headaches or swollen ankles. Avoid drinking large amounts of grapefruit juice.

Alcohol

Both amlodipine and ramipril lower your blood pressure. Drinking alcohol can further increase this effect, making you feel dizzy, lightheaded, or faint, especially when you first start the medicine or move to a higher dose. It is best to keep alcohol intake to a minimum.

Salt substitutes (Potassium-based)

Ramipril can increase the levels of potassium in your blood. Many salt substitutes (such as Lo-Salt) contain potassium instead of sodium. Using these while taking ramipril can cause your potassium levels to become dangerously high. Check with your pharmacist before using salt substitutes.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.