Gingival hyperplasia: Should drug interaction be blamed for?

Indian J Pharmacol. 2017 May-Jun;49(3):257-259. doi: 10.4103/ijp.IJP_57_17.

Abstract

Gingival overgrowth (GO) is one of the common findings in clinical practice. There could be several causes including drugs associated with the GO. Carbamazepine (CBZ) and amlodipine are the drugs which are infrequently documented as a cause in inducing the gingival hyperplasia. Certain drugs in the body fluid might limit the population of plaque bacteria and alter their metabolism that in turn induce the inflammatory mediators and also activate the genetic and biochemical factors responsible for gingival fibroblast growth. Drug-induced GO is a side effect with a multifactorial etiology that seems to orchestrate the interaction between drugs and fibroblasts in the gingiva. We describe a case of trigeminal neuralgia with hypertension treated with multiple drugs including amlodipine and CBZ. Although amlodipine is known to be infrequently associated with GO, an association of CBZ with GO is even rarer. Causality analysis on the World Health Organization Uppsala Monitoring Centre's scale indicates a probable association with offending drugs.

Keywords: Amlodipine; carbamazepine; gingival overgrowth; pharmacovigilance.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amlodipine / adverse effects
  • Amlodipine / therapeutic use
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / therapeutic use
  • Carbamazepine / adverse effects
  • Carbamazepine / therapeutic use
  • Drug Interactions
  • Female
  • Gingival Hyperplasia / chemically induced*
  • Gingival Hyperplasia / pathology
  • Humans
  • Trigeminal Neuralgia / complications
  • Trigeminal Neuralgia / drug therapy

Substances

  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Amlodipine
  • Carbamazepine