Abstract

AMLODIPINE INDUCED PEDAL PITTING EDEMA: A CASE REPORT

Battu Rakesh* and Jaladi Himaja

ABSTRACT

Amlodipine is a third generation calcium channel blocker used in adults and children above 6 years old for the treatment of hypertension, angina and other coronary artery disease. Calcium channel blocker act by inhibiting the inward movement of calcium by binding to voltage sensitive L-Type calcium channels and alpha-1 subunit in the heart and in smooth muscle of coronary and peripheral vasculature which leads to prevent the entry of calcium in to the cells finally no excitation-contraction coupling in the heart and vascular smooth muscles to smooth muscle dilation and relaxation. It is absorbed slowly after oral administration. The drug exhibits constant pharmacokinetics and pharmacodynamics and well tolerated but its bioavailability is high. It has a longer duration of action than a nifedipine. Amlodipine which was introduced as the third generation, exhibits longer half-life and most potent anti-hypertensive agent as compared to the previous generation agents. Ankle edema is one of the most frequent adverse effects of amlodipine often leading to noncompliance and discontinuation of an effective antihypertensive drug. It dilates both peripheral as well as coronary vessels. It is an alternative anti-hypertensive drug for patients with Nifedipine induced pedal oedema. This drug is expected to produce a more incidence of pedal oedema, as compared to nefidipine and other calcium channel blockers, based on the limited data available from clinical trials. Amlodipine has more incidence of pedal edema than the other calcium channel blockers. We report a case of Amlodipine induced pedal oedema. Here we present a case of 49 years old male patient diagnosed with Hypertension, Type II diabetes mellitus and Acute Coronary Syndrome who gradually develops pitting type pedal edema after the initiation of oral amlodipine 5mg for the treatment of hypertension. The symptoms improved on cessation of amlodipine and the patient was managed with an alternative antihypertensive agent.

Keywords: Amlodipine, Calcium Channel Blocker, pedal oedema, Hypertension, Type-II Diabetes Mellitus, Acute Coronary Syndrome.