Probable amlodipine-induced angioedema.
OBJECTIVE
To report a case of angioedema likely associated with amlodipine administration in a patient with a right thalamic hemorrhagic stroke.


METHODS
A 50-year-old female experienced angioedema during hospitalization for a right thalamic hemorrhagic stroke. She had no past history of angioedema and all of her medications were assessed for risk of angioedema. After careful evaluation, case reports linking calcium channel blockers (CCBs) and angioedema led to further examination of amlodipine as a cause. Amlodipine therapy had been initiated 24 hours prior to the development of angioedema, which then resolved 72 hours after discontinuation of the drug. In total, the patient experienced oropharyngeal swelling for 10 days.


CONCLUSIONS
In determining a cause for the patient's angioedema we eliminated genetic, allergic, physically induced, thyroid autoimmune disease-associated, and medication-induced causes. Three case reports describing 7 patients have linked the CCBs verapamil, diltiazem, and nifedipine with angioedema. The onset and resolution of symptoms in our patient were very similar to those seen in other case reports. Application of the Naranjo probability scale found a probable link between amlodipine and angioedema.


CONCLUSIONS
Although few reports of CCB-induced angioedema exist, to our knowledge, this is the first reported case to suggest a link between angioedema and amlodipine therapy. Clinicians should consider amlodipine as a potential cause of angioedema.
Southward
Jessica
J
Pharmacy and Drug Information, Grady Health System, Atlanta, GA, USA. jsouthward@gmh.edu
Irvine
Elizabeth
E
Rabinovich
Marina
M
D017311:Amlodipine / Q000009:adverse effects* / Q000627:therapeutic use; D000799:Angioedema / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D020521:Stroke / Q000150:complications / Q000188:drug therapy
D002121:Calcium Channel Blockers; D017311:Amlodipine