Can Amlodipine Cause Swollen Gums? Understanding the Connection to Gingival Overgrowth

October 11, 2025 •

4 min read

With over 70 million annual prescriptions in the US, many people wonder: can amlodipine cause swollen gums? Yes, it can, as this is a known, though often underestimated, side effect of this common blood pressure medication. The condition, known as gingival overgrowth, involves the non-inflammatory enlargement of gum tissue and is a key adverse event associated with the drug.

Quick Summary

Amlodipine can cause gingival overgrowth, leading to swollen gums. The condition is manageable through improved oral hygiene, dosage adjustment, or switching to an alternative medication.

Key Points

Amlodipine can cause swollen gums: Known medically as gingival overgrowth, this is a possible side effect of the common blood pressure medication amlodipine.
Mechanism involves collagen imbalance: The drug's effect on calcium regulation can interfere with the breakdown of collagen in gum tissue while stimulating its production, leading to tissue buildup.
Oral hygiene is a major risk factor: Poor dental hygiene, including the presence of dental plaque, exacerbates the gum overgrowth by contributing to local inflammation.
Management includes medication change: The condition is often reversible by stopping amlodipine and switching to an alternative antihypertensive medication under a doctor's supervision.
Treatment options exist: Other treatments involve improved oral hygiene, professional dental cleanings, and, in severe cases, surgical removal of the excess gum tissue.
Prevalence may be higher than reported: Recent case studies and literature reviews suggest the incidence of this side effect may be higher than previously estimated in standard drug information resources.
Early detection is key: Notifying your doctor or dentist of any new gum swelling early can prevent progression and more invasive treatments.

What is Amlodipine-Induced Gingival Overgrowth (AIGO)?

Drug-induced gingival overgrowth (DIGO) is a known side effect of certain medications, and amlodipine, a calcium channel blocker, is one of the implicated agents. AIGO is a condition characterized by the non-inflammatory enlargement of the gum tissue, often appearing firm, dense, and fibrotic. While the incidence of this side effect with amlodipine is lower compared to some other calcium channel blockers like nifedipine, it is a significant issue for those affected. Case reports show that Amlodipine-Induced Gingival Overgrowth can occur at various doses and durations of treatment, though some studies suggest higher doses may carry a greater risk.

How Amlodipine Causes Swollen Gums

The exact mechanism is not fully understood, but a few hypotheses have been proposed to explain how amlodipine and other calcium channel blockers lead to gum overgrowth. One leading theory involves the medication's effect on calcium regulation and its impact on gingival fibroblasts, which are cells responsible for producing and maintaining connective tissue.

Calcium Ion Inhibition: Amlodipine blocks the influx of calcium ions into cells. In gingival fibroblasts, this may interfere with the normal enzymatic processes that regulate collagen breakdown. Specifically, the enzyme collagenase, which breaks down old collagen, requires calcium to function. When calcium uptake is inhibited, the degradation of collagen slows down.
Excess Collagen Production: Simultaneously, some studies suggest that amlodipine stimulates gingival fibroblasts to produce more collagen and other connective tissue components.
Inflammatory Response: A unifying theory suggests that the drug's effect is magnified by the presence of inflammation. The concentration of the drug in the gingival crevicular fluid, combined with local irritants like dental plaque, can trigger an inflammatory response. This, in turn, can further stimulate fibroblast activity and contribute to the overgrowth.
Genetic Predisposition: Not all individuals taking amlodipine develop gingival overgrowth, which points to a potential genetic susceptibility. Individual differences in how the body metabolizes the drug or how gingival fibroblasts respond to it may play a role.

Recognizing the Symptoms

Amlodipine-induced gingival overgrowth typically begins within the first few months to a year after starting the medication and often starts with the interdental papillae, the gum tissue between the teeth.

Here are the common symptoms to look for:

Visible Gum Enlargement: The most obvious sign is the thickening of gum tissue, which can cover portions of the teeth. The gums may look lumpy, hard, and thick.
Bleeding Gums: Inflammation caused by plaque buildup on the overgrown tissue can lead to bleeding while brushing or flossing.
Poor Oral Hygiene: The enlarged tissue can make it difficult to brush and floss effectively, which can worsen inflammation.
Changes in Tooth Alignment: In severe, untreated cases, the growing gum tissue can cause teeth to shift or become loose.
Aesthetic Concerns: The altered gum contour can be a significant cosmetic issue for many patients.

Treatment and Management of Swollen Gums

The primary approach to managing Amlodipine-Induced Gingival Overgrowth is to address the underlying cause while managing the symptoms.

Consult with a Physician: The first and most critical step is to talk to your prescribing doctor. They may consider switching to an alternative antihypertensive medication from a different class, such as an angiotensin receptor blocker (e.g., losartan), which is known to be effective for this issue. In some cases, a different calcium channel blocker with less risk, like benidipine, may be an option.
Improve Oral Hygiene: Meticulous oral hygiene is paramount. This includes proper brushing, regular flossing, and potentially using antiseptic oral rinses. This helps reduce the inflammatory component of the overgrowth.
Professional Dental Cleaning: Regular scaling and root planing by a dental professional are essential to remove plaque and calculus that can aggravate the condition.
Surgical Intervention: In moderate to severe cases, or if the enlargement persists after medication change and improved hygiene, surgical removal of the excess gum tissue (gingivectomy) may be necessary.

Comparison of Drug-Induced Gingival Overgrowth

Several classes of drugs are known to cause gingival overgrowth. Here is a comparison of some common examples, including amlodipine.


Feature	Amlodipine (Calcium Channel Blocker)	Nifedipine (Calcium Channel Blocker)	Cyclosporine (Immunosuppressant)	Phenytoin (Anticonvulsant)
Prevalence	Relatively low (~3%) but higher than previously reported.	Higher (~10%) and a more frequent cause.	High prevalence, especially in transplant patients (~25%).	High prevalence (~50%), one of the most common causes.
Mechanism	Interferes with collagen breakdown and increases synthesis in fibroblasts.	Similar mechanism to amlodipine, affecting calcium regulation in gingival tissue.	Affects fibroblasts and collagen synthesis, potentially involving inflammatory mediators.	Inhibits folate uptake in fibroblasts, reducing collagenase activity.
Associated Factors	Dose, duration, and oral hygiene influence severity.	Good oral hygiene can reduce the severity of the overgrowth.	Often influenced by dose and systemic factors in transplant patients.	Strongly associated with poor oral hygiene and dose.
Management	Switch to an alternative medication, emphasize oral hygiene, and consider surgery.	Can be managed by changing medications or through surgical removal.	Often requires alternative immunosuppression or surgical removal.	Requires strict oral hygiene and possible medication change or surgery.

Conclusion

While a less common side effect than with some other medications, amlodipine can indeed cause swollen gums, a condition known as gingival overgrowth. This effect is typically linked to a complex interaction involving the drug, the patient's individual susceptibility, and oral hygiene status. The condition often reverses upon discontinuation of amlodipine and can be significantly improved with a diligent oral hygiene regimen and professional dental care. It is crucial for patients experiencing this side effect to consult with both their doctor and dentist to explore alternative treatments and manage their oral health effectively. Being aware of this potential adverse effect allows for its early detection and management, preventing more severe complications like tooth movement or psychosocial distress.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or before making decisions about your treatment.

Frequently Asked Questions

Amlodipine-induced gingival overgrowth is the non-inflammatory enlargement of gum tissue that occurs as an adverse side effect of taking the medication amlodipine.

Gingival enlargement can begin anywhere from a few months to a year after starting amlodipine. Some cases have even been reported with short-term, low-dose use.

Yes, in many cases, the gingival overgrowth is reversible. Switching to a different class of medication, along with improved oral hygiene, can lead to a significant reduction or complete resolution of the swelling over time.

While gingival overgrowth can occur at both low and high doses, some reports indicate that higher doses may increase the risk and severity. However, the link is not consistently reported in all studies.

You should immediately consult your prescribing physician and a dental professional. Your doctor may recommend switching medications, and your dentist can help manage the condition with improved oral hygiene and professional cleaning.

Yes, other calcium channel blockers, such as nifedipine, are also known to cause gingival overgrowth. Different classes of antihypertensives, like angiotensin receptor blockers (e.g., losartan), are considered safer alternatives in such cases.

No, surgery is typically reserved for severe cases or when the swelling persists after medication is changed and oral hygiene is optimized. Nonsurgical management, including drug substitution and meticulous oral hygiene, is the first-line approach.

Yes, maintaining meticulous oral hygiene, including regular brushing and flossing, is crucial. It helps reduce inflammation caused by plaque buildup, which exacerbates the overgrowth.