Can Amlodipine Cause Erythema Multiforme? What Patients Need to Know

October 13, 2025 •

3 min read

According to the FDA and medical literature, erythema multiforme is a very rare but recognized dermatological side effect associated with the use of amlodipine. This potentially serious skin reaction can occur as a hypersensitivity response to the medication, emphasizing the importance of recognizing unusual skin changes while on treatment.

Quick Summary

Amlodipine can cause erythema multiforme, but it is an exceptionally rare hypersensitivity reaction. A range of other, more common skin issues are also possible, underscoring the need for vigilance and prompt medical advice if a rash appears.

Key Points

Amlodipine can cause erythema multiforme: While extremely rare, amlodipine is a recognized trigger for this serious skin hypersensitivity reaction.
EM manifests as 'target' lesions: This distinctive rash, often accompanied by vesicles or blisters, can appear on the skin and mucous membranes.
Rarity is key to context: The incidence of amlodipine-induced erythema multiforme is less than 0.01%, making it a statistically uncommon event.
Discontinuation is the first step: If a drug-induced rash is suspected, stopping the medication is the primary management strategy and often leads to resolution.
Other skin reactions are more common: Patients are more likely to experience milder side effects like flushing, general rash (maculopapular), or pruritus.
Immediate medical attention is necessary: Patients showing signs of severe skin reactions like EM, SJS, or TEN require urgent medical evaluation.
Mucosal involvement is a major red flag: If a rash is accompanied by sores or erosions in the mouth, eyes, or genitals, it could indicate a more severe condition.

Amlodipine and Cutaneous Adverse Reactions

Amlodipine is a widely prescribed calcium channel blocker used to treat hypertension and coronary artery disease. While generally well-tolerated, it is associated with a spectrum of side effects, including several that manifest on the skin. The most common of these include peripheral edema, flushing, and non-specific rashes. However, patients and healthcare providers must be aware of the potential for more severe and rare cutaneous adverse drug reactions (CADRs), such as erythema multiforme (EM), which is a serious, inflammatory condition of the skin and mucous membranes.

The Rare Link to Erythema Multiforme

While many skin reactions linked to amlodipine are minor, case reports and surveillance data have confirmed a link between the drug and the onset of erythema multiforme. The manufacturer's labeling and other pharmacovigilance reports list EM as a very rare event, with an incidence of less than 0.01%. This means that while the risk is low, it is not zero, and clinicians should keep it in mind when evaluating a patient presenting with new skin lesions. Other drugs, notably antibiotics, NSAIDs, and anticonvulsants, are more frequently implicated in drug-induced EM, but calcium channel blockers like amlodipine are also known culprits in a smaller percentage of cases.

What is Erythema Multiforme?

Erythema multiforme is an immune-mediated hypersensitivity reaction that presents with distinctive, target-like lesions on the skin. The condition is often classified as minor or major, depending on the severity and extent of involvement.

Erythema Multiforme Minor: Characterized by typical target lesions on the skin, often in an acral distribution (hands, feet, elbows, knees) with no or minimal mucosal involvement.
Erythema Multiforme Major: Involves more widespread skin lesions and affects at least two mucosal sites, commonly the lips, mouth, eyes, or genitals.

Recognizing Amlodipine-Induced Skin Reactions

When a new rash develops, especially shortly after starting a new medication like amlodipine, careful evaluation is crucial. The following list details the range of potential skin reactions, from common and mild to rare and severe:

Common Reactions (1-10% incidence):
- Flushing (sudden warmth and redness)
- Peripheral Edema (swelling of ankles or feet)
Uncommon Reactions (0.1-1% incidence):
- Pruritus (itching)
- Rash (often maculopapular)
- Photosensitivity (increased skin reaction to sun)
Very Rare Reactions (<0.01% incidence):
- Erythema Multiforme (target lesions)
- Angioedema (rapid swelling of face, lips, tongue, or throat)
- Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN): Life-threatening conditions causing widespread skin blistering and peeling
- Exfoliative Dermatitis (widespread skin peeling)

Comparison of Skin Reactions Associated with Amlodipine

To help distinguish between the different types of skin reactions, the table below compares the key features of erythema multiforme with more common and less serious rashes associated with amlodipine use.


Feature	Erythema Multiforme (EM)	Common Rash (e.g., maculopapular)	Flushing
Prevalence	Very rare (<0.01%)	Common (1-10%)	Common (1-10%)
Appearance	Target-shaped lesions; potential for vesicles or blisters	Red, bumpy rash	Redness and warmth of skin
Mucosal Involvement	Common in EM major (lips, mouth, eyes, genitals)	Rare or absent	Absent
Systemic Symptoms	May be present (e.g., fever, malaise)	Generally absent	Absent
Severity	Serious, potentially severe; requires immediate medical attention	Mild to moderate; resolves upon drug discontinuation	Mild, temporary; often lessens with continued use
Required Action	Stop drug immediately; seek urgent medical evaluation	Report to doctor; may not require stopping medication	Monitor; often not medically significant

Management and Treatment

If a patient develops any suspicious rash while taking amlodipine, especially one with concerning features like target lesions or blisters, they should contact their doctor immediately. In cases of drug-induced erythema multiforme, the primary treatment is to discontinue the suspected medication, which in this instance would be amlodipine. For mild to moderate reactions, treatment may include topical corticosteroids and antihistamines for symptomatic relief. Severe cases, especially EM major, may require hospitalization for supportive care, fluid management, and systemic corticosteroids. Rechallenging the patient with amlodipine is not recommended once a hypersensitivity reaction like EM has occurred.

Conclusion

While the answer to "Can amlodipine cause erythema multiforme?" is yes, it is important to remember that this side effect is exceedingly rare. The majority of skin-related adverse reactions to amlodipine are far less severe, such as flushing and general rash. Nonetheless, clinicians and patients should remain vigilant for the signs of serious hypersensitivity reactions, including EM, SJS, and TEN, and seek immediate medical help if symptoms arise. Recognizing the potential link and acting quickly can prevent serious complications. For accurate drug information and potential side effects, consult reliable sources like MedlinePlus.

Frequently Asked Questions

No, erythema multiforme is a very rare side effect of amlodipine, occurring in less than 0.01% of patients.

The rash typically consists of distinctive 'target' or 'iris' lesions, which may be accompanied by vesicles or blisters and can affect both the skin and mucous membranes.

If you notice a new rash, especially one with unusual features, you should contact your healthcare provider immediately. For serious reactions like EM, discontinuation of the drug is often required.

Yes, other skin reactions are more common, including flushing (redness and warmth), maculopapular rash, pruritus (itching), and photosensitivity.

Yes, although also very rare, severe cutaneous reactions like SJS and TEN have been reported in association with amlodipine use.

Skin reactions can occur within days or weeks of starting amlodipine. The timing is a critical clue for healthcare providers in determining causality.

There is a possibility of cross-reactivity among calcium channel blockers. After a serious reaction, a doctor will likely recommend switching to a different class of medication entirely to avoid a recurrence.