A rare case of accelerated gingival overgrowth with high dose amlodipine therapy

Introduction: Gingival overgrowth represents an over-exuberant response to a variety of local and systemic conditions. Certain anticonvulsants, immunosuppressive drugs, and a number of calcium channel blockers have been shown to produce similar gingival overgrowth in susceptible patients. Case report: 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. Conclusions: Among the calcium channel blockers, nifedipine is most frequently associated with gingival overgrowth. Whereas, there is limited evidence of amlodipine-induced gingival hyperplasia.

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Amlodipine Induced Gum Hypertrophy – A Rare Case Report

Current Drug Safety ◽

10.2174/1574886316666211122125215 ◽

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.

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

BMJ Case Reports ◽

10.1136/bcr-2019-229587 ◽

2019 ◽

Vol 12 (5) ◽

pp. e229587 ◽

Cited By ~ 8

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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Laser Therapy In Drug Induced Gingival Hyperplasia- A Case Report

10.51626/ijoh.2021.01.00008 ◽

2021 ◽

Vol 1 (2) ◽

Keyword(s):

Case Report ◽

Calcium Channel ◽

Laser Therapy ◽

Calcium Channel Blockers ◽

Treatment Modalities ◽

Personal Satisfaction ◽

Channel Blockers ◽

Gingival Hyperplasia ◽

Bacterial Burden ◽

Drug Induced

Gingival excess is related with various components including innate infections, hormonal unsettling influences, helpless oral cleanliness condition, aggravation, neoplastic conditions, and unfavorable medication responses including anticonvulsants, calcium channel blockers, and immunosuppressants. This can have an inconvenient impact on the personal satisfaction and furthermore on high oral bacterial burden brought about by plaqueretentive regions. Different treatment modalities incorporate both careful (gingivectomy, periodontal fold, electrosurgery, and laser extraction) and nonsurgical methodologies. This case report reveals the treatment of drug induced gingival hyperplasia with laser

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EFFECTIVENESS OF NON-SURGICAL PERIODONTAL THERAPY ON AMLODIPINE INDUCED GINGIVAL ENLARGEMENT: A CASE REPORT

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i11.722 ◽

2019 ◽

Vol 3 (11) ◽

Author(s):

Dagar Mona ◽

Kataria Prerna

Keyword(s):

Case Report ◽

Calcium Channel ◽

Calcium Channel Blockers ◽

Normal State ◽

Periodontal Therapy ◽

Channel Blockers ◽

Scaling And Root Planing ◽

Drug Induced ◽

Gingival Overgrowth ◽

Gingival Enlargement

Gingival enlargement, [sometimes abbreviated to GO (gingival overgrowth)] is an increase in the size of the gingiva. It is a common feature of gingival disease. Gingival enlargement is a well known side-effect of drugs like anticonvulsants, calcium channel blockers and immunosuppressant. A case of amlodipine induced gingival enlargement was reported and after drug substitution when the patient was treated non-surgically (scaling and root planing), the enlargement subsides to a normal state which suggested the effectiveness of non-surgical periodontal therapy in the treatment of drug induced gingival enlargement. Keywords: Anticonvulsants, Immunosuppressants, Calcium channel blockers, gingival enlargement

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

ISRN Dentistry ◽

10.5402/2011/497850 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 10

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.

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Drug-Induced Gingival Overgrowth: A Pilot Study on the Effect of Diphenylhydantoin and Gabapentin on Human Gingival Fibroblasts

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218229 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8229

Author(s):

Dorina Lauritano ◽

Giulia Moreo ◽

Luisa Limongelli ◽

Elena Tregambi ◽

Annalisa Palmieri ◽

...

Keyword(s):

Extracellular Matrix ◽

Direct Action ◽

Human Fibroblasts ◽

Matrix Metalloproteases ◽

Channel Blockers ◽

Gingival Hyperplasia ◽

Drug Induced ◽

Gingival Overgrowth ◽

Matrix Deposition ◽

Extracellular Matrix Deposition

Introduction. The administration of several classes of drugs can lead to the onset of gingival overgrowth: anticonvulsants, immunosuppressants, and calcium channel blockers. Among the anticonvulsants, the main drug associated with gingival overgrowth is diphenylhydantoin. Materials and Methods. In this study, we compared the effects of diphenylhydantoin and gabapentin on 57 genes belonging to the “Extracellular Matrix and Adhesion Molecule” pathway, present in human fibroblasts of healthy volunteers. Results. Both molecules induce the same gene expression profile in fibroblasts as well as a significant upregulation of genes involved in extracellular matrix deposition like COL4A1, ITGA7, and LAMB3. The two treatments also induced a significant downregulation of genes involved in the expression of extracellular matrix metalloproteases like MMP11, MMP15, MMP16, MMP24, and transmembrane receptor ITGB4. Conclusions. Data recorded in our study confirmed the hypothesis of a direct action of these drugs at the periodontium level, inducing an increase in matrix production, a reduction in its degradation, and consequently resulting in gingival hyperplasia.

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