Area of Science:

• Cardiovascular medicine
• Pharmacology

Background:

• Pedal oedema is a common adverse effect of amlodipine.
• Diuretics are generally ineffective for managing amlodipine-induced pedal oedema.

Approach:

• This review prioritizes strategies to minimize side effects.
• It outlines various management options for amlodipine-induced pedal oedema.

Key Points:

• Reducing amlodipine dosage to half the maximum recommended dose can significantly decrease the incidence of pedal oedema.
• Effective management strategies include dose reduction, switching to alternative antihypertensives like lercanidipine or lacidipine, or changing to a different drug class.
• Adding or increasing the dosage of ACE-inhibitors or angiotensin II-receptor blockers, administering amlodipine at night, or switching to verapamil or diltiazem are also viable options.
• Non-pharmacologic interventions or observation are suitable for mild, non-bothersome oedema.

Conclusions:

• Minimizing amlodipine dosage is key to preventing pedal oedema.
• A stepwise approach, starting with dose reduction and progressing to alternative medications or strategies, is recommended for effective management.