Amlodipine 10 mg to 5 mg + Losartan 50 mg, AM dosing (12 wks update): Female, 63, hypertension with early chronic kidney disease (eGFR 62) — what worked for others here?
Female, 63, hypertension with early chronic kidney disease (eGFR 62). On amlodipine 10 mg, I had pitting ankle swelling by evening, and my shoes stopped fitting. My prescriber lowered amlodipine to 5 mg each morning and added losartan 50 mg for BP and kidney protection. Objective changes: ankle circumference fell from 24.5 cm to 22.5 cm over 4 weeks. Home BP (validated cuff, 7-day average) went from 138/84 to 128/78. A BMP at week 2 showed potassium 4.6 mEq/L, creatinine up slightly from 0.95 to 1.05 mg/dL, which my doctor considered acceptable. I elevated my legs 20 minutes each evening and wore 15-20 mmHg compression stockings during the day. I skipped potassium supplements. Swelling did not vanish entirely, but it became manageable, so I rate it 4 out of 5.
The FDA DailyMed Norvasc label shows peripheral edema of 3.0% at 5 mg versus 10.8% at 10 mg, and adding an ARB or ACE inhibitor lowers edema incidence in published analyses. The losartan label notes that creatinine rises under about 30% from baseline after starting are often tolerated, but larger rises warrant evaluation.