Can amlodipine (calcium channel blocker) cause ankle swelling?

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From the FDA Drug Label

Edema 1.8 3.0 10.8 0.6 ... Edema 5.6 14.6 1.4 5.1 ... swelling of your legs or ankles

Amlodipine can cause ankle swelling, as indicated by the presence of edema and swelling of the legs or ankles in the list of possible side effects. The incidence of edema was reported to be dose-related, with a higher incidence at higher doses of amlodipine 1. Additionally, the drug label for amlodipine besylate tablets, USP, lists swelling of the legs or ankles as a possible side effect 1. Key points:

  • Edema is a reported side effect of amlodipine
  • The incidence of edema is dose-related
  • Swelling of the legs or ankles is a possible side effect of amlodipine besylate tablets, USP

From the Research

Yes, amlodipine can cause ankle swelling, which is one of its most common side effects, affecting approximately 16.6% of patients, as reported in a meta-analysis of randomized, placebo-controlled trials 2.

Causes and Mechanism

The mechanism behind this side effect involves the medication's action on blood vessels, where amlodipine dilates arterioles more than veins, creating a pressure imbalance that forces fluid into surrounding tissues, particularly in the ankles and feet due to gravity.

Incidence and Risk Factors

The incidence of peripheral edema is higher with amlodipine compared to placebo, with a risk ratio of 2.9, and is more common at higher doses (10 mg versus 5 mg daily) 2. However, up to one-third of edema cases on amlodipine might not be induced by amlodipine, as suggested by a meta-analysis 2.

Management and Recommendations

If you experience troublesome ankle swelling while taking amlodipine, don't stop the medication abruptly, but consult your healthcare provider. They might recommend strategies like:

  • Elevating your legs
  • Reducing salt intake
  • Possibly switching to a different blood pressure medication if the swelling is severe or bothersome It's essential to note that amlodipine is a widely used and effective medication for hypertension, and the benefits of treatment often outweigh the risks of side effects like ankle swelling, as highlighted in a recent review of amlodipine in the current management of hypertension 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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