Amlodipine is a third generation dihydropyridine calcium channel blocker that is frequently used in therapy of hypertension.
Among many side effects, amlodipine has been found associated with gingival overgrowth (GO) which usually occurs within
the first three months of starting therapy at a dose of 10 mg/day. However, there are very few reports on amlodipine-induced
gingival overgrowth (AIGO) at a lower dose (5 mg/day) and only after short term administration. A 64-year-old male patient with
hypertension, who received amlodipine (5 mg/day) for four years, sought medical attention at the Department of Periodontology
and Oral Medicine, Institute of Dentistry, Banja Luka, Bosnia and Herzegovina. The patient complained of masticatory problems
due to extensive maxillary GO along with pain, bleeding, and foul odor. The clinical and the histological evidences were consistent
with AIGO. The first line treatment consisted of the amlodipine substitution (amlodipine was replaced with enalapril, 5 mg/day)
and the scaling and root planning/SRP. At one-month follow-up, drug replacement and SRP resulted in some reduction of the
inflammation and significant reduction of symptoms. Further, gingivectomy/gingivoplasty helped overcome the effect of these
drugs. The possibility of AIGO should be considered for a lower dose, as well as a late presentation.
