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Amlodipine oedema — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsAmlodipine oedemaGPhC CRA

A 69-year-old woman with hypertension develops ankle swelling three weeks after starting amlodipine 10mg daily. Her blood pressure is controlled, she is not breathless, and examination by the GP found no pulmonary crackles. What is the most appropriate alternative?

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Correct answer: B — Discuss dose reduction or switching antihypertensive therapy with the prescriber

Peripheral oedema is a recognised dose-related adverse effect of amlodipine. In the absence of features of heart failure, adding a loop diuretic is usually not the best solution because the mechanism is arteriolar vasodilation rather than fluid overload. Dose reduction or switching therapy should be considered by the prescriber. The patient should also be assessed for red flags such as unilateral swelling or breathlessness if present.

Reference: BNF; NICE CKS Hypertension