Drug-Induced Oedema — RACP Adult Medicine MCQ

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EasyClinical PharmacologyDrug-Induced OedemaRACP Adult Medicine

A 55-year-old woman on amlodipine presents with bilateral lower limb oedema. She is concerned about heart failure. Her NT-proBNP is 45 pg/mL and echocardiography is normal. What is the most likely cause of her oedema?

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Correct answer: B — Amlodipine-induced peripheral oedema

Peripheral oedema is a common adverse effect of dihydropyridine calcium channel blockers (amlodipine, nifedipine), occurring in up to 10–30% of patients at higher doses. It is caused by preferential arteriolar vasodilation leading to increased capillary hydrostatic pressure, NOT fluid retention. Normal NT-proBNP and echocardiography exclude heart failure. Strategies include dose reduction, switching agents, or adding an ACE inhibitor/ARB (which cause venodilation, reducing capillary pressure).

Reference: AMH – 2025 – Calcium Channel Blockers; eTG – 2025 – Cardiovascular