I was prescribed enalapril 5 mg without being hypertensive, only to control the blood pressure spikes that appear during my fibromyalgia flare-ups. Instead of enalapril 5 mg, could I take amlodipine 5 mg?
Answered by Dr Florian André Vallecillo Cabrera · María
Hello, María.
In principle, it is not advisable to replace enalapril with amlodipine on your own initiative, even though both medications are used to treat high blood pressure.
Enalapril and amlodipine belong to different families and act through different mechanisms. The choice of one or the other depends on factors such as age, associated conditions, kidney function, other treatments and the reason why blood pressure rises.
If your blood pressure spikes appear only during fibromyalgia pain flare-ups, it is important to assess whether these rises are a transient response to pain and stress. In many cases, the best treatment is to control the fibromyalgia flare-up properly, since as the pain decreases, blood pressure usually normalises.
If enalapril was prescribed specifically for those occasional spikes, I advise you not to switch it for amlodipine without first consulting the doctor who knows your medical history. If you have had side effects with enalapril, such as a persistent cough, dizziness or any other discomfort, there are alternatives that may be more suitable, but the decision must be individualised.
In addition, it would be advisable to have several blood pressure measurements, both during flare-ups and in pain-free periods, to confirm whether hypertension really exists or whether these are only transient rises related to pain.
Key points:
• Do not replace one antihypertensive with another without medical indication.
• Intense pain can cause transient rises in blood pressure.
• If elevated readings persist outside the flare-ups, a work-up to rule out hypertension is advisable.
• Seek urgent care if you have very high blood pressure accompanied by chest pain, difficulty breathing, visual disturbances, weakness or neurological symptoms.
I hope this has been helpful.
Kind regards,
Dr Florian André Vallecillo Cabrera
Informational answer, medically validated. It does not replace an in-person consultation or an individual diagnosis.