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Scholars Journal of Applied Medical Sciences | Volume-3 | Issue-04
Replacement of Amlodipine with Cilnidipine and assessment of pedal edema along with blood pressure control
Dr. Ravi Shankar Prasad
Published: July 28, 2015 | 98 368
DOI: 10.36347/sjams.2015.v03i04.014
Pages: 1680-1682
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Abstract
Amlodipine, an L- type calcium channel blocker (CCB) is the most commonly used antihypertensive drug. Pedal edema is a common adverse effect of amlodipine. Cilnidipine, a newer L/N-type CCB, is also an effective antihypertensive. The Aim of this study was to determine whether cilnidipine can resolve amlodipine-induced edema along with adequate control of hypertension. This was a prospective, observational study done at the tertiary care centre of Central India. A total number of 50 (n = 50) patients of essential hypertension with amlodipine-induced edema of either gender, attending outpatient department of medicine, were included in the study. Concomitant nephropathy, cardiac failure, hepatic cirrhosis, or other causes of edema, and secondary hypertension were excluded by appropriate tests. Amlodipine therapy was substituted in all the cases with an efficacy-equivalent dose of cilnidipine. Clinical assessment of pedal edema and measurement of bilateral ankle circumference, body weight, blood pressure, and pulse rate were performed at onset of the study and after 4 weeks of cilnidipine therapy. At completion of the study, edema had resolved in all the patients. There was a significant decrease in bilateral ankle circumference and body weight (P < 0.001). There was no significant change in mean arterial blood pressure and pulse rate. Therapy with cilnidipine resulted in complete resolution of amlodipine-induced edema in all the cases without worsening of hypertension or tachycardia. Cilnidipine is an acceptable alternative antihypertensive for patients with amlodipine-induced edema.