Does amlodipine cause swelling
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Amlodipine and Its Association with Swelling
Introduction to Amlodipine and Swelling
Amlodipine, a widely prescribed calcium channel blocker (CCB), is primarily used to treat hypertension, angina, and coronary artery disease. Despite its therapeutic benefits, amlodipine has been associated with several adverse drug reactions, including various forms of swelling.
Angioedema and Amlodipine
Angioedema Incidents
Angioedema, characterized by deep swelling beneath the skin, is a documented but uncommon side effect of amlodipine. Several case reports have highlighted instances where patients developed angioedema shortly after starting amlodipine. For example, a 50-year-old female experienced oropharyngeal swelling 24 hours after initiating amlodipine, which resolved 72 hours after discontinuation. Similarly, a 38-year-old man presented with severe upper lip swelling, which improved after stopping amlodipine and receiving treatment with glucocorticoids and diphenhydramine.
Mechanism and Clinical Implications
The exact mechanism by which amlodipine induces angioedema is not fully understood. However, it is crucial for clinicians to recognize this potential side effect, especially since the onset and resolution of symptoms can closely follow the administration and withdrawal of the drug .
Peripheral Edema and Amlodipine
Prevalence and Dose-Dependence
Peripheral edema, particularly in the lower extremities, is a more common side effect of amlodipine. A meta-analysis of randomized, placebo-controlled trials found that patients on amlodipine had a significantly higher rate of peripheral edema compared to those on placebo (16.6% vs. 6.2%). The risk of edema was dose-dependent, with higher doses (10 mg) associated with a greater incidence of edema compared to lower doses (2.5-5 mg).
Clinical Observations
Clinical observations have consistently reported cases of ankle and leg swelling in patients taking amlodipine. For instance, a 32-year-old female developed ankle and leg swelling after one week of amlodipine therapy, which subsided upon discontinuation of the drug. Another study noted that amlodipine blunted postural vasoconstriction, leading to increased leg weight and fluid retention.
Gingival Overgrowth and Amlodipine
Case Reports
Gingival overgrowth is another form of swelling associated with chronic amlodipine use. A case report described a 9-year-old girl who developed gingival overgrowth after three years of amlodipine therapy, which improved after the drug was discontinued. Similarly, a 12-year-old boy experienced labial gingival swelling due to amlodipine, which resolved after stopping the medication.
Mechanism and Management
The mechanism behind amlodipine-induced gingival overgrowth is thought to involve the drug's effects on cellular proliferation and extracellular matrix production. Management typically involves discontinuation of the drug and alternative antihypertensive therapy .
Conclusion
Amlodipine, while effective for managing hypertension and angina, can cause various forms of swelling, including angioedema, peripheral edema, and gingival overgrowth. These side effects are dose-dependent and can significantly impact patient quality of life. Clinicians should be vigilant in monitoring for these adverse reactions and consider alternative treatments if necessary.
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