scholarly journals Cyclosporine and Amlodipine Induced Severe Gingival Overgrowth - Etiopathogenesis and Management of a Case with Electrocautery and Carbon-Dioxide(CO2) Laser

2012 ◽  
Vol 6 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Rashmi Hegde ◽  
Rahul Kale ◽  
A Sanjay Jain
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Side Effect ◽  
Channel Blockers ◽  
Gingival Overgrowth ◽  
Supportive Periodontal Therapy ◽  
Wide Range ◽  
Carbon Dioxide Co2 ◽  
Oral Hygiene Instructions

ABSTRACT Gingival overgrowth is a well recognized, unwanted side-effect associated with three major drugs/drug groups – phenytoin, cyclosporine and the calcium channel blockers. Cyclosporine is a potent immunosuppressive compound that has been used increasingly in conjunction with kidney, heart and other transplants. Calcium channel blockers are widely used in medical practice for the management of cardiovascular disorders. Due to their wide range of use, gingival overgrowth is now a recognized side-effect associated with them. Here we discuss a case report dealing with severe gingival overgrowth induced by cyclosporine and amlodipine. A 36-year-old man who underwent renal transplant came with a chief complaint of generalized gingival swelling. He had very severe gingival overgrowth in both arches and required thorough scaling and oral hygiene instructions, followed by supportive periodontal therapy for 4 months, after which radical gingivectomy using electrocautery and CO2 laser was performed. The post operative results were excellent and there was no recurrence at 1 year follow-up.

scholarly journals Phenytoin-Induced Gingival Overgrowth: A Review of the Molecular, Immune, and Inflammatory Features

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Jôice Dias Corrêa ◽  
Celso Martins Queiroz-Junior ◽  
José Eustáquio Costa ◽  
Antônio Lúcio Teixeira ◽  
Tarcilia Aparecida Silva
Keyword(s):  
Extracellular Matrix ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Side Effect ◽  
Channel Blockers ◽  
Connective Tissues ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Matrix Metabolism

Gingival overgrowth (GO) is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. GO is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. One of the main drugs associated with GO is the antiepileptic phenytoin, which affects gingival tissues by altering extracellular matrix metabolism. Nevertheless, the pathogenesis of such drug-induced GO remains fulfilled by some contradictory findings. This paper aims to present the most relevant studies regarding the molecular, immune, and inflammatory aspects of phenytoin-induced gingival overgrowth.

Amlodipine Induced Gum Hypertrophy – A Rare Case Report

2021 ◽  
Vol 16 ◽  
Author(s):  
Suryanarayana Challa Reddy ◽  
Naresh Midha ◽  
Vivek Chhabra ◽  
Deepak Kumar ◽  
Gopal Krishna Bohra
Keyword(s):  
Calcium Channel ◽  
Side Effect ◽  
Antihypertensive Drugs ◽  
Case Reports ◽  
Diagnostic Procedures ◽  
Channel Blockers ◽  
Gingival Hyperplasia ◽  
Drug Induced ◽  
Duration Of Action ◽  
Gingival Overgrowth

Background: DIGO or drug-induced gingival overgrowth occurs as a side effect of certain drugs. Until now, the etiology of drug-induced gingival overgrowth is not clearly understood. Among the calcium channel blockers, nifedipine has been shown to be most frequently associated with drug-induced gingival hyperplasia. Amlodipine is a comparatively newer calcium channel blocker that witha longer duration of action and lesser side effects as compared to nifedipine. There are only certain case reports of amlodipine-induced gum hyperplasia. Case presentation: We report a case of amlodipine-induced gum hyperplasia in a 66-year-old hypertensive patient taking amlodipine at a dose of 5 mg once a day. There was significant regression of gum hypertrophy after substitution of amlodipine by Losartan. Conclusion: Amlodipine is one of the commonly prescribed antihypertensive drugs, and gingival hyperplasia is one overlooked side effect in patients taking amlodipine. Awareness of this potential side effect of amlodipine may be helpful to reduce the anxiety of patients and the cost of diagnostic procedures.

scholarly journals Association of Angiotensin II–Stimulating Antihypertensive Use and Dementia Risk

Neurology ◽  
2020 ◽  
Vol 96 (1) ◽  
pp. e67-e80
Author(s):  
Jan Willem van Dalen ◽  
Zachary A. Marcum ◽  
Shelly L. Gray ◽  
Douglas Barthold ◽  
Eric P. Moll van Charante ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Excess Mortality ◽  
Population Sample ◽  
Community Dwelling ◽  
Channel Blockers ◽  
Dementia Risk ◽  
Incident Dementia

ObjectiveTo assess whether angiotensin II–stimulating antihypertensives (thiazides, dihydropyridine calcium channel blockers, and angiotensin I receptor blockers) convey a lower risk of incident dementia compared to angiotensin II–inhibiting antihypertensives (angiotensin-converting enzyme inhibitors, β-blockers, and nondihydropyridine calcium channel blockers), in accordance with the “angiotensin hypothesis.”MethodsWe performed Cox regression analyses of incident dementia (or mortality as competing risk) during 6–8 years of follow-up in a population sample of 1,909 community-dwelling individuals (54% women) without dementia, aged 70–78 (mean 74.5 ± 2.5) years.ResultsAfter a median of 6.7 years of follow-up, dementia status was available for 1,870 (98%) and mortality for 1,904 (>99%) participants. Dementia incidence was 5.6% (27/480) in angiotensin II–stimulating, 8.2% (59/721) in angiotensin II–inhibiting, and 6.9% (46/669) in both antihypertensive type users. Adjusted for dementia risk factors including blood pressure and medical history, angiotensin II–stimulating antihypertensive users had a 45% lower incident dementia rate (hazard ratio [HR], 0.55; 95% CI, 0.34–0.89) without excess mortality (HR, 0.86; 95% CI, 0.64–1.16), and individuals using both types had a nonsignificant 20% lower dementia rate (HR, 0.80; 95% CI,0.53–1.20) without excess mortality (HR, 0.97; 95% CI, 0.76–1.24), compared to angiotensin II–inhibiting antihypertensive users. Results were consistent for subgroups based on diabetes and stroke history, but may be specific for individuals without a history of cardiovascular disease.ConclusionsUsers of angiotensin II–stimulating antihypertensives had lower dementia rates compared to angiotensin II–inhibiting antihypertensive users, supporting the angiotensin hypothesis. Confounding by indication must be examined further, although subanalyses suggest this did not influence results. If replicated, dementia prevention could become a compelling indication for older individuals receiving antihypertensive treatment.

Abstract 12688: Long Term Use of Calcium Channel Blockers and Risk of Breast Cancer Development

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Uyen T Lam ◽  
Stacey Knight ◽  
Tami L Bair ◽  
Viet T Le ◽  
Joseph B Muhlestein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Positive Family History ◽  
Channel Blockers ◽  
Increased Risk ◽  
History Of ◽  
Incident Breast Cancer

Introduction: Calcium channel blockers (CCBs) are a mainstay in treating hypertension (HTN). Recently, Li et-al published a population based case-control study (JAMA 2013; 289:2354) reporting CCB use to be associated with incident breast cancer (odds ratio 2.6). We prospectively analyzed 2 Intermountain Healthcare (IHC) databases (db) to confirm or refute this provocative report. Methods: Two separate analyses were conducted using general patients (GP) seen at IHC and patients undergoing coronary angiography (CV) at IHC facilities. Subjects were females aged 50-70 with no history of breast cancer. Those prescribed CCB were matched 1:1 to subjects not on CCB based on age, race, tobacco, alcohol, body mass index, HTN and follow up time. Multivariable Cox proportional hazards regression was used for the primary analysis of time to incident breast cancer by CCB use adjusting for history of other cancers and family history of breast cancer. Results: A total of 2612 GP subjects (cases/controls) and 1106 CV subjects (cases/controls) were studied. In the GP db, there was a statistically significant increased risk of breast cancer for subjects using CCB (HR=1.58; 95% CI: 1.10-2.26). Risk was also associated with a positive family history (HR=2.79; 1.96-3.97) and a personal history of cancer (HR=1.87; 1.07-3.26). Breast cancer predominantly developed in <5 y of follow up (64% of cases). However, a reverse relationship was found in the CV db, where the HR was 0.51 (95% CI: 0.27-0.97). This observation was found despite consistent associations with several secondary outcomes, including for incident diabetes, coronary and renal disease. Conclusion: A modest association between CCB use and incident breast cancer was observed in the GP db, but results were not reproducible in the CV db. Given lack of a credible mechanism and failure of previous randomized CCB studies to detect a signal, we interpret these modest and conflicting associations to likely represent uncorrected confounding, e.g. prescriber bias or drug interactions. Similarly, we believe the results of Li et-al may represent confounding. Given the important role of CCBs in clinical medicine, further studies are warranted, including randomized trials to assess CCB safety with respect to breast cancer risk.

Treatment of calcium channel blocker-induced gingival overgrowth without modifying medication

2021 ◽  
Vol 14 (1) ◽  
pp. e238872 ◽  
Author(s):  
Satoru Morikawa ◽  
Mana Nasu ◽  
Yoko Miyashita ◽  
Taneaki Nakagawa
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Calcium Channel Blockers ◽  
Channel Blocker ◽  
Periodontal Treatment ◽  
Common Side Effect ◽  
Channel Blockers ◽  
Gingival Overgrowth ◽  
Old Japanese ◽  
Almost All

Gingival overgrowth is a common side effect of calcium channel blockers used in the treatment of cardiovascular diseases. While controversial, management includes discontinuing the calcium channel blocker. We report the case of a 66-year-old Japanese man with hypertension and type 2 diabetes mellitus who was diagnosed with severe periodontitis covering almost all the teeth. The patient had been on nifedipine (40 mg/day) and amlodipine (10 mg/day) medication for 5 years. With his physician’s consent, nifedipine was discontinued during his treatment for periodontitis, which consisted of oral hygiene instructions and scaling and root planing on all areas. Gingivectomy was performed on the areas of hard fibrous swelling. Nifedipine was resumed during periodontal treatment when the patient’s hypertension worsened. His periodontal scores improved when he resumed treatment. We report that significant improvement in gingival overgrowth can occur with basic periodontal treatment, surgery and sustained intensive follow-up without adjusting calcium channel blockers.

scholarly journals Amlodipine induced generalized gingival overgrowth: A clinical case

2021 ◽  
Vol 6 (2) ◽  
pp. 125-127
Author(s):  
Sayani Shome ◽  
Amit De ◽  
Arup Ghosh ◽  
Ankita Saraf
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Geriatric Patient ◽  
Clinical Case ◽  
Gingival Tissue ◽  
Channel Blockers ◽  
Unique Case ◽  
Gingival Overgrowth ◽  
Management Protocol ◽  
Gingival Enlargement

Calcium channel blockers (CCB) like Amlodipine, Nifedipine etc are widely used as anti-hypertensive drugs which on chronic intake shows gingival enlargement. It is an iatrogenic response of gingival tissue to these drugs along with other category of medications like antiepileptics and immunosuppressants. A unique case of long standing gingival overgrowth due to prolonged usage of CCB such as Amlodipine in a geriatric patient are portrayed herewith clinical, histopathological attributes and management protocol.

Influence of 3 calcium channel blockers on gingival overgrowth in a population of severe refractory hypertensive patients

2018 ◽  
Vol 53 (5) ◽  
pp. 721-726 ◽  
Author(s):  
F. Vidal ◽  
R. C. de Souza ◽  
D. C. Ferreira ◽  
R. G. Fischer ◽  
L. S. Gonçalves
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Channel Blockers ◽  
Hypertensive Patients ◽  
Gingival Overgrowth

scholarly journals Cyclosporine A and amlodipine induced gingival overgrowth in a kidney transplant recipient: case presentation with literature review

2019 ◽  
Vol 12 (5) ◽  
pp. e229587 ◽  
Author(s):  
Tarun Nanda ◽  
Baljeet Singh ◽  
Parul Sharma ◽  
Karandeep Singh Arora
Keyword(s):  
Calcium Channel ◽  
Kidney Transplant ◽  
Cyclosporine A ◽  
Calcium Channel Blockers ◽  
Kidney Transplant Recipient ◽  
Kidney Transplant Patient ◽  
Channel Blockers ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Gingival Enlargement

Drug-induced gingival overgrowth is a condition caused by side effects of treatment with one of three types of drugs: phenytoin (used in epilepsy treatment), cyclosporine A (used in transplantology after allogenic organ transplants) and calcium channel blockers (used in the treatment of hypertension). Gingival overgrowth leads to inflammation within the gums and periodontium and can amplify the existing periodontal disease leading to tooth loss. Patients who have undergone kidney transplant are given immunosuppressants to prevent transplant rejection and mostly it is accompanied with calcium channel blockers to treat hypertension associated with kidney transplant. This article reports a case of recent gingival enlargement associated with cyclosporine A and amlodipine given to a kidney transplant patient from the past 11 years.

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