Subtherapeutic doses of angiotensin receptor blocker for attenuation of amlodipine-induced peripheral edema

Peripheral edema is one of the commonest troublesome adverse effects associated with the use of calcium channel blockers (CCBs). Here, we report a case of amlodipine-induced peripheral edema which could be adequately managed by subtherapeutic doses of angiotensin receptor blocker (ARBs); telmisartan. An elderly hypertensive patient prescribed amlodipine developed edema on both lower limbs to the extent of limiting her normal function and was thus changed to telmisartan monotherapy. Eventually, failure of antihypertensive response to maximal doses of telmisartan (80 mg) despite disappearance of edema made low-dose combination therapy inevitable for achievement of dual goals-Target blood pressure with limitation of adverse effect (edema). To conclude, we come up with two suggestions-First, ARBs can be added to CCBs even in patients who respond to monotherapy with CCBs in order to reduce the incidence of edema and thus improve compliance. Second, when used for attenuation of edema with amlodipine, we suggest use of titrated doses of ARBs.