The NHS has issued a crucial advisory for individuals taking medications like amlodipine and ramipril to control their blood pressure. In the UK, approximately one-third of adults grapple with hypertension, a condition that becomes more prevalent with advancing age.

Often referred to as the “silent killer,” hypertension typically presents no symptoms. Nonetheless, it poses serious health risks by placing undue stress on the heart and blood vessels, potentially leading to heart attacks, strokes, and heart failure. While adopting a healthier lifestyle, such as reducing processed food consumption and increasing physical activity, is vital, medication is frequently prescribed to help manage high blood pressure.

Among the most commonly prescribed medications for this condition is ramipril. Recent data reveals that this drug, which works by dilating blood vessels, was prescribed approximately 34.8 million times in the past year.

Amlodipine, another widely used treatment, accounts for more than 30 million prescriptions annually. This calcium channel blocker helps to relax the arteries, further aiding in blood pressure management.

The NHS has highlighted important advice for patients taking these blood pressure medications. According to their guidance, some individuals may require adjustments to their prescribed dosages.

As detailed on the NHS website, there is a note of caution: “Taking other medicines that lower blood pressure, such as ramipril or lisinopril, alongside amlodipine can sometimes result in your blood pressure dropping too low.”

“When your blood pressure is low, you may experience dizziness or fainting. If this keeps happening to you, tell your doctor as your dose may need to be changed.”

The main symptoms of low blood pressure, known as hypotension, include sensations of dizziness, light-headedness, blurred vision, fainting episodes, nausea, and weakness. It is crucial to have a blood pressure assessment if these symptoms occur regularly.

Certain medications may interfere with the effectiveness of amplodipine so it’s important to inform you’re doctor of what you’re taking. They include:

• antibiotics such as clarithromycin, erythromycin or rifampicin
• calcium channel blockers like diltiazem or verapamil
• itraconazole or ketoconazole, antifungal medicines
• medicines to treat HIV or HCV (hepatitis C virus)
• anti-epilepsy medicines such as carbamazepine, phenytoin, phenobarbital (phenobarbitone) or primidone
• medicines to suppress your immune system, such as ciclosporin or tacrolimus
• more than 20mg a day of the cholesterol-lowering medicine simvastatin

Ramipril or lisinopril can typically be prescribed alongside amlodipine as it represents a widely used and proven therapeutic pairing. However, combining these medications can increase the likelihood of hypotension, potentially resulting in light-headedness or loss of consciousness.

On herbal treatments and dietary supplements, the NHS advises: “St John’s wort, a herbal remedy taken for depression, is thought to affect the way amlodipine works. Talk to your doctor if you’re thinking about taking St John’s wort.

“There’s not enough information to say that other herbal remedies or supplements are safe to take with amlodipine. They’re not tested in the same way as pharmacy and prescription medicines.

“They’re generally not tested for the effect they have on other medicines. Tell your doctor or pharmacist if you’re taking any other medicines, including herbal remedies, vitamins or supplements.”