Gingival overgrowth (GO) is the excessive proliferation of gingival soft tissue in response to a variety of local and systemic conditions. Certain anticonvulsants, immunosuppressive drugs and calcium channel blockers have been shown to produce a similar response in susceptible patients. Among the calcium channel blockers, nifedipine is most frequently associated with gingival overgrowth. Whereas there is limited evidence of amlodipine induced gingival hyperplasia. We report a case of accelerated drug induced gingival overgrowth in a 60-year-old hypertensive patient taking amlodipine at a dose of 10 mg within three months of initiation of therapy.
Amlodipine is a frequently prescribed first line drug in the management of hypertension and angina pectoris. It inhibits intracellular Ca2+ uptake and thereby stimulates functionally susceptible gingival fibroblasts to build-up collagen in the extracellular matrix. Interleukin-6 also plays an important role in the fibrogenic response of gingiva to these medications. The association between GO and calcium channel blockers is understood to be dose dependent. This case report highlights the need for physicians to be cognizant of rare side effects like accelerated gingival overgrowth seen with the use of high dose amlodipine. Early recognition and timely integrated intervention by medical and dental physicians, is vital for its successful management.
Keywords: Adverse drug reaction, Calcium channel blockers, Drug-induced gingival hyperplasia, Hypertension
Abbreviations: GO- Gingival Overgrowth
