Demonstration of resolution of amlodipine induced pedal edema by cilnidipine

The aim of the study is to demonstrate the resolution of Amlodipine induced pedal edema by substitution of Cilnidipine with an adequate hypertension control. This was a prospective, Interventional study. Conducted at the tertiary care center in south India. A total number of 66 (n = 66) patients with essential hypertension with the amlodipine-induced edema of both genders, attending the outpatient department of medicine and cardiology, were included in the study. Amlodipine induced pedal edema was confirmed by various tests. After the Initial screening, amlodipine therapy was substituted to Cilnidipine with an efficacy equivalent dose. Clinical and biochemical parameters measured at the onset of the study and reassessed after 4 weeks of Cilnidipine therapy. At the end of the study, amlodipine-induced pedal edema was completely resolved in all the patients. There was a significant decrease in vanillyl mandelic acid (VMA) and (P <0.001), which is end metabolite of catecholamine. There was a substantial reduction in bilateral ankle circumference, Body weight and BMI (P <0.001). There was a significant decrease in blood pressure and pulse rate (P <0.001). Cilnidipine therapy leads to a complete resolution of amlodipine-induced edema, along with a better hypertension control. Cilnidipine is decreasing the release of catecholamine by inhibiting N-type of calcium channels at the neuronal terminal. Cilnidipine is a suitable alternative antihypertensive medication for patients with the amlodipine-induced edema.