Moderate
Amlodipine × carvedilol
Calcium channel blockers (dihydropyridines)×Alpha and beta blocker (non-selective β + α1)
Mechanism
Additive hypotension and peripheral oedema. Amlodipine causes ankle oedema; the beta-blocker (carvedilol) may potentiate fluid retention.
Symptoms
Lower-leg and ankle oedema, weight gain. Hypotension and dizziness on standing. Worsening dyspnoea in heart failure patients.
Management
Standard combination in ischaemic heart disease with hypertension. In heart failure with reduced ejection fraction, titrate carefully and monitor weight and dyspnoea. For marked ankle oedema: switch to lercanidipine (less oedema among dihydropyridines).
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Sources
- ESC: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2021)– Eur Heart J 2021;42(36):3599–3726