Gingival Hyperplasia Associated with the Administration of Amlodipine to Dogs with Degenerative Valvular Disease (2004–2008)

Abstract

Background: Calcium channel blocking drugs, usually nifedipine and less often amlodipine, have been reported to cause gingival hyperplasia (GH) in humans. Hypothesis: Amlodipine, a dihydropyridine calcium channel blocking drug, can cause GH when administered chronically to older small dogs with degenerative valvular disease. Animals Studied: From January 2004 to May 2008, 82 client‐owned dogs with degenerative valvular disease and left atrial dilatation were treated with amlodipine in combination with spironolactone and enalapril and followed for >6 months. Methods: Retrospective study. A chronological observation of GH in 2 dogs treated with amlodipine in 2004 and 2006 prompted the study. Patient histories and medical records of each dog treated with amlodipine for degenerative valvular disease from January 2004 to May 2008 were reviewed. Results: GH was observed by clients and the authors in 7 of 82 (8.5%) dogs. Histologic confirmation of the diagnosis was made in 2 dogs. The minimum duration of treatment before diagnosis of GH was 5 months. GH began to resolve within 2 weeks of discontinuing amlodipine and resolution was complete within 6 months. Amlodipine administration was reinstituted in 1 dog in which GH had resolved, and GH reoccurred within 4 months. Conclusion and Clinical Importance: Long‐term administration of amlodipine to dogs with degenerative valvular disease may cause GH in a small percentage of patients. GH resolves quickly after withdrawal of amlodipine treatment.

Comparative effects of amlodipine and benazepril on Left Atrial Pressure in Dogs with experimentally-induced Mitral Valve Regurgitation

“…In dogs with MR, amlodipine increases cardiac out put, therefore, decreases the volume of regurgitation relatively across a mitral valve. So, our results suggest amlodipine has beneficial effect on LAP in dogs with MR. Also, in the present study, adverse effects of amlodipine were not observed but we feel this warrants further examination because there is a report that long-term administration of amlodipine to dogs with mitral regurgitation may cause gingival hyperplasia in a small percentage of patients [24]. …”

Occurrence of systemic hypertension in dogs with acute kidney injury and treatment with amlodipine besylate

“…The most common adverse effects reported in human beings treated with amlodipine are oedema, dizziness, fatigue, and heart palpitations (Osterloh 1991, Webster and others 1993, Burges and Moisey 1994, Weir 2003). Systemic hypotension is a rare but reported complication in cats, and gingival hyperplasia has been described in dogs treated with amlodipine over several months (Henik and others 1997, Thomason and others 2009). In our study, no adverse reactions were recorded, possibly because of careful titration of amlodipine, frequent post‐treatment monitoring, and the short overall duration of treatment.…”

Gingival overgrowth induced by nifedipine: Gingiva and drugs

“…Prilikom pregleda uočeno je da je uglavnom labijalna gingiva prednjih donjih ine, a calcium-channel blocker used in the treatment of angina pectoris. Both clinically and histologically, the condition resembled other cases of drug-induced gingival overgrowth 4,5 . Nifedipine is a relatively new and increasingly used medication for treatment of all kinds of angina pectoris and arterial hypertension 6 .…”

“…Since then, other medications have been associated with gingival overgrowth, such as cyclosporine, an immunosuppressive agent 2 , sodium valproate, an anti-epileptic agent 3 , and nifedip-se koristi u lečenju angine pektoris, povezivana sa uvećanjem gingive. Stanje je, klinički i histološki, ličilo na gingivalna uvećanja izazvana drugim lekovima 4,5 . Nifedipin je relativno nov lek koji se sve više koristi za lečenje svih vrsta angine pektoris i arterijske hipertenzije 6 .…”