Healthy Gums Does It Matter?Amlodipine-Induced Gingival Overgrowth (AIGO): A Case Report
DOI:
https://doi.org/10.70672/a3rjbb14Keywords:
Hypertension, Gingival Overgrowth, dihydropyridine calcium channel blockerAbstract
In Malaysia, more than half a million adults, representing 2.5% of the population, are living with four major non-communicable diseases (NCDs): diabetes, hypertension, hypercholesterolemia, and obesity. As for hypertension, 29.2% or 1 in 3 adults in Malaysia have hypertension, and 91% are on blood pressure medications. This includes dihydropyridine calcium channel blockers such as amlodipine, which is commonly used in primary care. We report a case from our primary care clinic involving a 70-year-old man with a known history of primary hypertension who developed painless gum swelling and discomfort while the patient was on T. amlodipine 10 mg. Oral examination showed diffuse gingival hypertrophy involving the upper and right lower gums. The condition resolved completely after discontinuation of the offending drug and substitution with an angiotensin-converting enzyme inhibitor. This case is notable because the gingival overgrowth developed only after 4 years of amlodipine 10 mg therapy. This paper aims to bring clinicians' attention to these adverse effects of amlodipine, so that timely and effective management can be given to the patient, avoiding complications and unnecessary treatment.
References
[1]. Nyska A., Shemesh M., Tal H., and Dayan D., Gingival hyperplasia induced by calcium channel blockers: mode of action, Medical Hypotheses. (1994) 43, no. 2, 115–118, https://doi.org/10.1016/0306-9877(94)90061-2, 2-s2.0-0028141631
[2]. Lafzi A., Farahani R. M. Z., and Shoja M. A. M., Amlodipine-induced gingival hyperplasia, Medicina Oral, Patología Oral y Cirugía Bucal. (2006) 11, no. 6, E480–E482, 2-s2.0-39049182497.
[3]. Amlodipine-induced gingival hyperplasia. Lafzi A, Farahani RM, Shoja MA. https://pubmed.ncbi.nlm.nih.gov/17072250/ Med Oral Patol Oral Cir Bucal. 2006;11:0–2.
[4]. Brown, R.S.; Arany, P.R. Mechanism of Drug-Induced Gingival Overgrowth Revisited: A Unifying Hypothesis. Oral Dis. 2015, 21, e51–e61.
[5]. Srivastava A. K., Kundu D., Bandyopadhyay P., and Pal A. K., Management of amlodipine-induced gingival enlargement: series of three cases, Journal of Indian Society of Periodontology. (2010) 14, no. 4, 279–281, https://doi.org/10.4103/0972-124x.76931.
[6]. Livada R. and Shiloah J., Calcium channel blocker-induced gingival enlargement, Journal of Human Hypertension. (2014) 28, no. 1, 10–14, https://doi.org/10.1038/jhh.2013.47, 2-s2.0-84889671323.
[7]. Joshi S. and Bansal S., A rare case report of amlodipine-induced gingival enlargement and review of its pathogenesis, Case Reports in Dentistry. (2013) 2013, 3, 138248, https://doi.org/10.1155/2013/138248.
[8]. Nishikawa S., Nagata T., Morisaki I., Oka T., and Ishida H., Pathogenesis of drug-induced gingival overgrowth. A review of studies in the rat model, Journal of Periodontology. (1996) 67, no. 5, 463–471, https://doi.org/10.1902/jop.1996.67.5.463, 2-s2.0-0030139665.
[9]. Banthia R., Gupta S., Banthia P., Singh P., Raje S., and Kaur N., Is periodontal health a predictor of drug-induced gingival overgrowth? A cross-sectional study, Dental Research Journal. (2014) 11, no. 5, 579–584.
[10]. Seymour R. A., Ellis J. S., and Thomson J. M., The pathogenesis of drug-induced gingival overgrowth, Journal of Clinical Periodontology. (1996) 23, no. 3, 165–175, https://doi.org/10.1111/j.1600-051x.1996.tb02072.x, 2-s2.0-0030095969.
[11]. Triveni M. G., Rudrakshi C., and Mehta D. S., Amlodipine-induced gingival overgrowth, Journal of Indian Society of Periodontology. (2009) 13, no. 3, 160–163, https://doi.org/10.4103/0972-124x.60231.
[12]. Tavassoli S., Yamalik N., Çaǧlayan F., Çaǧlayan G., and Eratalay K., The clinical effects of nifedipine on periodontal status, Journal of Periodontology. (1998) 69, no. 2, 108–112, https://doi.org/10.1902/jop.1998.69.2.108, 2-s2.0-0031935781.
[13]. Morikawa S, Nasu M, Miyashita Y, Nakagawa T: Treatment of calcium channel blocker-induced gingival overgrowth without modifying medication. BMJ Case Rep. 2021, 14:e238872. 10.1136/bcr-2020-238872.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Asian Journal of Medicine & Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Journal of Engineering Technology (JET) is an open-access journal that follows the Creative Commons Attribution-Non-commercial 4.0 International License (CC BY-NC 4.0)
