Can amlodipine cause hair loss? An Evidence-Based Review

While hair loss is not listed as a common side effect in official prescribing information for amlodipine, some case reports and patient experiences suggest a potential link [1.3.3, 1.8.1]. Can amlodipine cause hair loss? The connection appears to be rare but warrants investigation.

Quick Summary

Amlodipine, a calcium channel blocker, is not officially recognized to cause hair loss, and it was not observed in clinical trials [1.3.4]. However, some case studies and anecdotal reports describe hair thinning, possibly due to a rare drug-induced telogen effluvium [1.3.1, 1.7.1, 1.8.2].

Key Points

• Not a Common Side Effect: Hair loss is not listed as a side effect in amlodipine's official FDA prescribing information or clinical trials [1.3.3, 1.3.4].

• Rare but Reported: Despite being officially unrecognized, there are individual case studies and anecdotal reports linking amlodipine to hair loss [1.3.1, 1.8.2].

• Telogen Effluvium: The likely mechanism for medication-induced hair loss is telogen effluvium, where hair follicles prematurely enter the 'resting' phase, causing shedding 2-4 months later [1.4.1, 1.7.4].

• Usually Reversible: Hair loss caused by medication is typically temporary and resolves within months after the causative drug is stopped under medical advice [1.6.1, 1.6.4].

• Consult a Doctor First: Never stop taking amlodipine or any other prescription medication without consulting your doctor, even if you suspect it's causing hair loss [1.6.1].

• Lower Risk Than Other Drugs: Amlodipine is less likely to cause hair loss compared to other blood pressure drug classes like beta-blockers or ACE inhibitors [1.5.1, 1.9.5].

• Alternative Medications Exist: If amlodipine is the suspected cause, a doctor may recommend switching to another class of antihypertensives, such as ARBs, which have a lower incidence of this side effect [1.9.2].

What is Amlodipine?

Amlodipine is a widely prescribed medication belonging to the drug class known as calcium channel blockers [1.3.2]. It is primarily used to treat high blood pressure (hypertension) and certain types of chest pain (angina) related to coronary artery disease [1.2.1, 1.3.2]. By relaxing and widening blood vessels, amlodipine improves blood flow, which helps to lower blood pressure and reduce the heart's workload [1.3.2]. Common side effects include swelling of the ankles or feet, dizziness, flushing, and headache [1.2.1, 1.2.5].

The Link Between Amlodipine and Hair Loss (Alopecia)

Official FDA-approved prescribing information and major clinical trials for amlodipine do not list hair loss (alopecia) as a recognized side effect [1.3.3, 1.3.4]. Many medical resources state that hair loss is not a common reaction to the drug [1.3.5, 1.9.5].

However, despite the absence of hair loss in large-scale studies, there are individual case reports and anecdotal patient experiences that suggest a possible connection [1.3.1, 1.8.1, 1.8.4]. The incidence is considered very rare, with some pharmacovigilance databases estimating it at less than 0.1% of patients [1.3.3]. One case study detailed a post-menopausal woman who experienced significant frontal hair loss while taking amlodipine, which improved after discontinuing the drug [1.3.1, 1.3.3].

Potential Mechanism: Telogen Effluvium

When medication is suspected of causing hair loss, the most common mechanism is a condition called telogen effluvium [1.4.4, 1.7.4]. The hair growth cycle has three main phases: anagen (growth), catagen (transition), and telogen (resting) [1.4.5]. Telogen effluvium occurs when a stressor—such as a new medication—causes a large number of hair follicles to prematurely enter the resting phase [1.4.3, 1.7.4]. This leads to diffuse hair shedding, typically noticed 2 to 4 months after starting the drug [1.4.1, 1.4.2].

Some researchers theorize that calcium channel blockers like amlodipine might interfere with calcium signaling in cells, which could disrupt hair follicle health, though this is not fully clear [1.7.2]. Another theory suggests the drug could reduce blood flow to the scalp or alter the balance of hormones and enzymes, but these mechanisms are not proven [1.3.2].

Comparison of Blood Pressure Medications and Hair Loss Risk

Not all blood pressure medications carry the same risk of causing hair loss. Understanding the differences can be helpful for patients and clinicians when choosing treatment options.

Drug Class	Examples	Association with Hair Loss	Mechanism (if known)
Beta-Blockers	Metoprolol, Propranolol, Atenolol	Known to cause hair thinning in some patients [1.5.1, 1.5.2, 1.5.4].	Believed to affect the hair growth cycle, pushing more hairs into the shedding phase [1.5.3].
ACE Inhibitors	Lisinopril, Enalapril, Ramipril	Can lead to hair loss, though it is considered a relatively rare side effect [1.5.1, 1.5.3, 1.9.1].	May alter nutrient delivery to hair follicles [1.5.3].
Calcium Channel Blockers	Amlodipine, Diltiazem, Nifedipine	Generally not associated with hair loss; reports are very rare [1.3.6, 1.9.5].	Unclear; may be related to telogen effluvium or altered blood flow [1.3.2, 1.7.1, 1.7.2].
Angiotensin II Receptor Blockers (ARBs)	Losartan, Valsartan	Not commonly associated with hair loss; often considered an alternative if hair loss occurs with other classes [1.9.2, 1.9.5].	Generally well-tolerated with minimal hair impact [1.9.2].
Diuretics	Hydrochlorothiazide	Have been reported to cause hair loss in some individuals [1.5.1].	Mechanism is not well-defined.

Managing Suspected Medication-Induced Hair Loss

If you suspect amlodipine or another medication is causing hair loss, the most important first step is to consult your healthcare provider. Never stop taking a prescribed medication without medical guidance [1.6.1, 1.6.6].

1. Medical Consultation: Your doctor can evaluate if the hair loss is related to the medication or another underlying cause, such as thyroid issues, nutritional deficiencies, or stress [1.6.1, 1.3.2].
2. Medication Adjustment: If the drug is determined to be the likely culprit, your doctor may suggest reducing the dose or switching to an alternative medication from a different class, such as an ARB, which has a lower risk of causing hair loss [1.6.2, 1.9.2].
3. Patience is Key: Drug-induced hair loss is typically reversible [1.6.1]. After stopping or changing the causative medication, hair shedding usually decreases over several months, with regrowth becoming evident within 3 to 6 months [1.6.4, 1.6.5]. However, it can take up to 18 months for hair to cosmetically recover [1.6.5].
4. Supportive Therapies: While waiting for regrowth, you can support hair health through a balanced diet rich in essential vitamins and minerals [1.6.3]. Gentle hair care practices, avoiding harsh chemical treatments and tight hairstyles, can also minimize further damage [1.6.3]. Topical treatments like minoxidil (Rogaine) may also be an option to stimulate growth [1.6.2, 1.6.4].

Conclusion

While the official data and large clinical studies do not recognize hair loss as a side effect of amlodipine, scattered case reports and patient accounts suggest it can occur in rare instances, likely through telogen effluvium [1.3.3, 1.3.4, 1.7.1]. Compared to other classes of blood pressure medications like beta-blockers and ACE inhibitors, amlodipine is considered to have a very low risk of causing alopecia [1.5.1, 1.9.5].

For individuals experiencing this distressing side effect, the prognosis is good, as the hair loss is usually reversible upon discontinuation of the medication under a doctor's supervision [1.6.1, 1.6.4]. If you are concerned about hair loss while taking amlodipine, open communication with your healthcare provider is essential to rule out other causes and determine the best course of action for managing both your blood pressure and your hair health.

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Authoritative Link: For comprehensive information on amlodipine, consult the MedlinePlus drug information page provided by the U.S. National Library of Medicine [1.2.1].

Frequently Asked Questions

Is hair loss a recognized side effect of amlodipine?

No, hair loss (alopecia) is not a recognized side effect in the official FDA-approved prescribing information for amlodipine, and it was not observed as a side effect in clinical trials [1.3.3, 1.3.4].

How common is hair loss with amlodipine?

Hair loss associated with amlodipine is considered extremely rare. Some pharmacovigilance databases report an incidence of less than 0.1%, or fewer than 1 in 1,000 patients [1.3.3].

If amlodipine causes hair loss, is it permanent?

No, in most cases, medication-induced hair loss is a form of telogen effluvium and is reversible. Hair typically begins to regrow within 3 to 6 months after the medication is stopped under a doctor's guidance [1.6.4, 1.7.2].

What should I do if I think amlodipine is making my hair fall out?

You should consult your doctor immediately. Do not stop taking the medication on your own. Your doctor can assess the cause and, if necessary, suggest a dose adjustment or switch you to an alternative blood pressure medication [1.6.1, 1.6.6].

Which blood pressure medications are more likely to cause hair loss than amlodipine?

Beta-blockers (like metoprolol and propranolol) and ACE inhibitors (like lisinopril) are more commonly associated with hair loss as a potential side effect compared to calcium channel blockers like amlodipine [1.5.1, 1.5.2, 1.5.3].

What is the mechanism by which some medications cause hair loss?

The most common mechanism is telogen effluvium, where the drug causes more hair follicles than normal to shift from the growth (anagen) phase to the resting (telogen) phase, leading to diffuse shedding a few months later [1.4.1, 1.4.4].

Are there blood pressure medications that don't cause hair loss?

Angiotensin II Receptor Blockers (ARBs), such as losartan and valsartan, are a class of blood pressure medication not commonly associated with hair loss and are often used as an alternative if this side effect occurs with other drugs [1.9.2, 1.9.5].