Can Amlodipine Cause Pseudogout?
No, amlodipine does not cause pseudogout. There is no evidence in the medical literature linking amlodipine to calcium pyrophosphate deposition disease (CPPD/pseudogout), and in fact, amlodipine may actually reduce the risk of crystal-induced arthropathies compared to other antihypertensive medications.
Evidence Supporting Amlodipine's Safety Regarding Crystal Arthropathies
Amlodipine significantly reduces gout risk compared to other antihypertensive agents in a large randomized trial, lowering gout incidence by 37% versus chlorthalidone and 26% versus lisinopril over nearly 5 years of follow-up 1.
The protective effect against crystal arthropathies appears after approximately 1 year of continuous therapy 1.
Calcium channel blockers like amlodipine are actually recommended as preferred antihypertensive agents in patients with gout, specifically because they do not increase uric acid levels or crystal deposition risk 2.
Medications That Actually Cause or Trigger Pseudogout
The following medications are known triggers for pseudogout, but amlodipine is not among them:
Diuretics (loop and thiazide) are well-established triggers for both gout and pseudogout attacks 2, 3.
Aspirin at varying doses can trigger crystal-induced arthritis 3.
Acute pseudogout may follow trauma, surgery, or acute medical illness rather than specific medications 3.
Clinical Context: What Actually Causes Pseudogout
Pseudogout results from calcium pyrophosphate dihydrate crystal deposition and is associated with:
Metabolic and endocrine disorders including hyperparathyroidism, hemochromatosis, and hypothyroidism 4.
Chronic renal failure, where the incidence increases to 15.8% in patients over age 60 undergoing hemodialysis 5.
Advanced age, typically affecting postmenopausal women and older adults 3.
Trauma or surgery to affected joints 3.
Practical Recommendation for Hypertension Management in Gout-Prone Patients
Choose amlodipine or other calcium channel blockers as first-line agents when managing hypertension in patients with gout or pseudogout 2, 1.
Avoid thiazide and loop diuretics when possible, as these increase crystal arthropathy risk; if a diuretic is necessary, consider substituting it 2.
Consider losartan (an ARB) as an alternative, as it has uricosuric properties 2.