Lisinopril/amlodipine explained

Lisinopril/amlodipine, sold under the brand name Lisonorm among others, is a medication used to treat high blood pressure.^[1] It is a combination of lisinopril an ACE inhibitor with amlodipine a calcium channel blocker.^[1] It may be used when blood pressure is not well controlled with each of the two agents alone.^[2] It is taken by mouth.^[1]

Side effects may include low blood pressure, kidney problems, liver problems, cough, and high blood potassium.^[2] It should not be used in people who have previously had angioedema due to ACE inhibitors.^[2] Use is not recommended during pregnancy or breastfeeding.^[2] Lisinopril works by decreasing angiotensin II and increasing bradykinin while amlodipine decreases the entry of calcium into the muscle cells in the heart and blood cells.^[2]

The combination was approved for medical use in the European Union in 2008.^[1] The combination on the World Health Organization's List of Essential Medicines.^{[3] [4]} While it is available in India and the European Union it is not available in Canada, Australia, or the United States as of 2019.^[5]

Pharmacology

Lisinopril/amlodipine is a combination of two agents which both act to induce vascular smooth muscle relaxation to lower blood pressure in distinct ways:

• Lisinopril inhibits angiotensin converting enzyme (ACE), the enzyme responsible for converting angiotensin I into angiotensin II (a vasoconstrictor).
• Amlodipine inhibits influx of calcium into smooth muscle cells through calcium channels thereby inhibiting Ca-dependent contraction.

Notes and References

1. Web site: Lisonorm . European Medicines Agency . 30 October 2019 . 24 March 2020 . https://web.archive.org/web/20200324104742/https://www.ema.europa.eu/en/medicines/human/referrals/lisonorm . live .
2. Web site: Summary of Product Characteritics . EMA . 15 November 2019 . 30 October 2019 . https://web.archive.org/web/20191030135214/https://www.ema.europa.eu/en/documents/referral/lisonorm-article-29-referral-annex-i-ii-iii_en.pdf . live .
3. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 21st list 2019 . 2019 . 10665/325771 . World Health Organization . World Health Organization . Geneva . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO . free .
4. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 22nd list (2021) . 2021 . 10665/345533 . World Health Organization . World Health Organization . Geneva . WHO/MHP/HPS/EML/2021.02 . free .
5. Web site: An application to include blood pressure lowering drug fixed dose combinations to the model list of essential medicines lists for the treatment of essential hypertension in adults . WHO . 15 November 2019 . 33 . 24 March 2020 . https://web.archive.org/web/20200324104744/https://www.who.int/selection_medicines/committees/expert/22/s12_FDC-antihypertensives-28Jan.pdf?ua=1 . live .