Amlodipine-induced gingival overgrowth

A 58-year-old man presented in our clinic with a complaint of painless gingival overgrowth (Figure 1). The patient was referred to our clinic by his dentist with the preliminary diagnosis of a drug-induced side effect. Gingival overgrowth involved the interdental papilla and marginal gingiva (Grade II-moderate overgrowth) localized on the anterolateral facial surface of the labial maxillary gingiva. Poor oral hygiene was observed. Medical history of the patient revealed that he had regularly received 10 mg amlodipine per day for three months for a recently diagnosed primary hypertension. Physical examination was non-specific, except the gingival overgrowth. Laboratory tests revealed hyperlipidemia. The medication was replaced with ramipril 10 mg/day and the patient was followed for two months. The diagnosis of gingival overgrowth was confirmed, as his symptoms disappeared. The case was classified as a probable adverse drug reaction based on six points of the Naranjo Adverse Drug Reaction Probability Scale. A written informed consent was obtained from the patient.