Amlodipine causing symptomatic bradycardia in a healthy 71-year-old male

Angie Tu , Seth Kabutey Adjovu

Case Reports in Internal Medicine ›› 2020, Vol. 7 ›› Issue (1) : 22 -26.

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Case Reports in Internal Medicine ›› 2020, Vol. 7 ›› Issue (1) :22 -26. DOI: 10.5430/crim.v7n1p22
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Amlodipine causing symptomatic bradycardia in a healthy 71-year-old male

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Abstract

Amlodipine is a calcium channel blocker that is well known to be vasoselective, thereby having minimal effects in cardiac tissue. However, recent literature have reported cases of symptomatic bradycardia associated with amlodipine use. We present a case of an otherwise healthy 71-year-old male who was found to have symptomatic bradycardia while taking amlodipine. He underwent comprehensive evaluation including an exercise stress echocardiogram during which he demonstrated chronotropic competence. Amlodipine was discontinued with return of his heart rate to baseline levels after 24 hours. There is a very low reported incidence of amlodipine-induced bradycardia (0.89% of cases). Despite its infrequency, it is important to recognize amlodipine-induced bradycardia as simply discontinuing the drug will lead to complete resolution of symptoms. Failure to recognize this side effect may lead to unnecessary healthcare costs and negatively impact patient outcomes.

Keywords

Amlodipine / Symptomatic bradycardia / Calcium channel blockers

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Angie Tu, Seth Kabutey Adjovu. Amlodipine causing symptomatic bradycardia in a healthy 71-year-old male. Case Reports in Internal Medicine, 2020, 7(1): 22-26 DOI:10.5430/crim.v7n1p22

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References

[1]

Burges R, Moisey D. Unique pharmacologic properties of amlodipine. Am J Cardiol. 1994; 73(3): A2-A9. https://doi.org/10.1016/0002-9149(94)90268-2

[2]

Nayler WG. Amlodipine: An overview. Clin Drug Invest. 1997; 13 (suppl 1): 1-11. https://doi.org/10.2165/00044011-199700131-00003

[3]

Amlodipine Besylate and EHealthMe.com,Bradycardia - from FDA Reports. 4 Nov. 2019. Available from: https://www.ehealthme.com/ds/amlodipine-besylate/bradycardia/

[4]

Ramadan R and Quyyumi A. A case of symptomatic bradycardia from amlodipine. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 338. J Hosp Med. 2010; 5 (suppl 1).

[5]

Welling A, Ludwig A, Zimmer S, et al. Alternatively Spliced IS6 Segments of the α1C Gene Determine the Tissue-Specific Dihydropyridine Sensitivity of Cardiac and Vascular Smooth Muscle LType Ca2+ Channels. Circ Res. 1997; 81: 526-532. PMid:9314833. https://doi.org/10.1161/01.RES.81.4.526

[6]

Angus JA, Wright CE, Xi Q. Targeting voltage-gated calcium channels in cardiovascular therapy. Lancet. 2000; 356(9238): 1287-1289. https://doi.org/10.1016/S0140-6736(00)02807-5

[7]

Haria M, Wagstaff AJ. Amlodipine: A reappraisal of its pharmacological properties and therapeutic use in cardiovascular disease. Drugs. 1995; 50(3): 560-586. PMid:8521773. https://doi.org/10.2165/00003495-199550030-00009

[8]

Murdoch D, Heel RC. Amlodipine: A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in cardiovascular disease. Drugs. 1991; 41(3): 478-505. PMid:1711448. https://doi.org/10.2165/00003495-199141030-00009

[9]

Taylor SH, Chen M, Lee S, et al. Efficacy and Tolerability of Amlodipine in the General Practice Treatment of Essential Hypertension in an Asian Multinational Population. Clin Drug Invest. 1998; 16(3): 177-185. PMid:18370538. https://doi.org/10.2165/00044011-199816030-00001

[10]

Welling A, Kwan YW, Bosse E, et al. Subunit-Dependent Modulation of Recombinant L-Type Calcium Channels: Molecular Basis for Dihydropyridine Tissue Selectivity. Circ Res. 1993; 73: 974-980. PMid:8403267. https://doi.org/10.1161/01.RES.73.5.974

[11]

Soldatov NM, Bouron A, Reuter H. Different Voltage-dependent Inhibition by Dihydropyridines of Human Ca2+ Channel Splice Variants. J Biol Chem. 1995; 270(18): 10540-10543. PMid:7737988. https://doi.org/10.1074/jbc.270.18.10540

[12]

DeWitt CR, Waksman JC. Pharmacology, Pathophysiology and Management of Calcium Channel Blocker and β-Blocker Toxicity. Toxicol Rev. 2004; 23(4): 223-238. PMid:15898828. https://doi.org/10.2165/00139709-200423040-00003

[13]

Lee DC, Greene T, Dougherty T, et al. Fatal nifedipine ingestions in children. J Emerg Med. 2000; 19(4): 359-361. https://doi.org/10.1016/S0736-4679(00)00266-3

[14]

Amlodipine besylate - Drug Summary.Prescriber’s Digital Reference, 14 Feb. 2020. Available from: https://www.pdr.net/drug-summary/Norvasc-amlodipine-besylate-1853#6

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