Volume 6 Issue 9 (September, 2018)

Original Articles

A Prospective clinical study to determine whether cilnidipine a dual L/N-type CCB drug therapy can produce resolution of amlodipine induced edema while maintaining adequate control of blood pressure
Jagjit Singh, Mukhtiar Singh, Kamaljit Singh, Ashish Puri, Kiran Kumar

Background: Pedal edema is a common adverse effect of amlodipine, an L-type calcium channel blocker, used as monotherapy for hypertension due to increased hydrostatic pressure across capillaries of dependent parts. Cilnidipine is a newer dual L/N-type CCB approved for treatment of essential hypertension that produces balanced vasodilation of – 'pre and post capillary bed' blood vessels and thus no change in hydrostatic pressure, rather it mitigates it, hence lesser incidence of edema of dependent parts. Materials and methods: A total 100 patients of primary hypertension on amlodipine treatment who met inclusion criteria were recruited in the study. Those having pedal edema as a side effect were identified clinically. In them amlodipine was stopped and were treated with equivalent dose of Cilnidipine. Baseline pedal edema was assessed by clinical method over medial malleolus of both legs before initiation of trial medication. Presence of pedal edema on either of the legs was considered as positive for the pedal edema. After initial screening – demographic data, past medical history, family history, and findings of clinical examination was recorded in the case report form.27 patients out of 100, who were having pedal edema were instructed to take the prescribed anti-hypertensive medication; Cilnidipine for 8 weeks duration as per physician’s advice. All the alterations occurring in the ankle circumferences and the hemodynamic parameters were summarized and analyzed by SPSS software. Results: There was a significant reduction in ankle circumference of both the feet at the end of the study. However no significant reduction in the mean pulse rate and mean arterial blood pressure was seen at the end of the study in comparison to the baseline values. Conclusion: Treatment with cilnidipine resolves amlodipine induced edema in all the patients without significant alterations in hypertension or tachycardia.
Key words: Amlodipine, CCB, Cilnidipine, Pedal edema.

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