Factors Influencing Gingival Overgrowth in Patients on Amlodipine and Nifedipine: A Systematic Review

Factors Influencing Gingival Overgrowth in Patients on Amlodipine and Nifedipine: A Systematic Review | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 8 January 2026 V1 Latest version Share on Factors Influencing Gingival Overgrowth in Patients on Amlodipine and Nifedipine: A Systematic Review Authors : Moataz darweesh 0009-0002-3702-2994 [email protected] , Baraa Abusaaid , Basel Jawhara , Rami Alsaghir , and Noora Almallouhi Authors Info & Affiliations https://doi.org/10.22541/au.176790826.67329655/v1 328 views 56 downloads Contents Abstract Aim of the study: Results: Discussion: Drug Type and Pharmacokinetics: Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Gingival overgrowth is a common and well-documented condition associated with the use of antihypertensive drugs, most notably amlodipine and nifedipine. This review aims to analyze various factors based on data collected from multiple studies and to summarize the findings to determine the influence of different variables. A slight male predominance was observed, and most cases occurred among patients aged between 50 and 60 years. The number of patients using amlodipine was higher than those using nifedipine. Gingival overgrowth most frequently occurred at doses below 5 mg per day, with the duration of drug intake most commonly ranging between 12 and 36 months. The analyzed factors included age, gender, type of drug, dosage, and duration of treatment. Aim of the study: The aim of this study is to analyze the various factors associated with this condition, including age, gender, dosage, duration of use, and comorbidities, and to record the differences in incidence rates. Additionally, we will summarize a number of case reports and individual studies conducted over the years into a comprehensive review. Results: Gender: Sex-based data were collected from 56 studies, comprising a total of 113 patients. Among them, 65 were males and 46 were females, corresponding to 57.5% males and 40.7% females. It is noteworthy that some studies did not report sex data (1.8%), which may influence the overall analysis. Age: The aggregated data from the included studies showed that the most common age range among patients taking Amlodipine and Nifedipine was between 50 and 60 years, with some cases reported in younger or older individuals. Drug Type and Pharmacokinetics: A total of 113 patients were included across the reviewed studies. Among them, 82 patients used Amlodipine, 29 used Nifedipine, 1 used Amlodipine + Metoprolol, and 1 used Felodipine. The average half-life of the drugs was as follows: Amlodipine: 30–50 hours Nifedipine: 2–7 hours The bioavailability (absorption rate) of these drugs was reported as follows: Amlodipine: 60–90% (well absorbed) Nifedipine: 45–68% (moderately absorbed) The average dosage ranges were : Amlodipine: 5–10 mg once daily (OD) Nifedipine: 30-60 mg once daily (OD) It was observed that Amlodipine and Nifedipine were the most frequently associated with gingival overgrowth, while felodipine was the least commonly reported. Dosage & Duration Dosage: We extracted 46 usable dosage entries (10 entries were not reported/available). Distribution by categories was: ≤5 mg/day: 17 (30.4%); 5-10 mg/day: 11 (19.6%); 10-40 mg/day: 15 (26.8%); 40-100 mg/day: 9 (16.1%); >100 mg/day: 4 (7.1%) Duration: We extracted 49 usable duration entries (7 entries not reported). Distribution by category was: 60 months: 7 (14.0%). Discussion: Gender & Age Interpretation: A few cases were recorded in younger ages, indicating that age is not the only factor influencing the development of gingival enlargement. Other contributing factors include medication dosage, type of drug used, oral hygiene, and individual tissue response. Based on these observations, it can be concluded that drug-induced gingival enlargement appears more frequently in older age groups, yet its occurrence in younger patients highlights the multifactorial nature of this condition. It can be generally inferred that sex-related differences in the prevalence of drug-induced gingival enlargement associated with antihypertensive medications are not substantial, or that a slight tendency toward males may exist according to the available data. Drug Type and Pharmacokinetics: The predominance of Amlodipine and Nifedipine among the reported cases may be explained by their widespread clinical use and relatively high bioavailability, which results in prolonged gingival tissue exposure. Amlodipine, with a long half-life (30–50 hours), provides stable plasma levels but may lead to chronic gingival stimulation over time, which could explain the tendency for slower healing and persistent enlargement once the condition develops. In contrast, Nifedipine has a shorter half-life (2–7 hours) and a more rapid onset, which might contribute to faster clinical enlargement but also quicker resolution once the drug is discontinued or substituted. Other antihypertensive medications such as felodipine, verapamil, and diltiazem were also reported in isolated cases However, the available data were insufficient to establish any meaningful correlation or statistical observation regarding their association with gingival enlargement. تشير هذه النتائج مجتمعةً إلى أن حركية الدواء وتوافره الحيوي قد يؤثران على تضخم اللثة الناتج عن الدواء. مع ذلك، فقد تم الإبلاغ عن حالات فردية لأدوية أخرى خافضة لضغط الدم، مثل فيلوديبين. يشير توزيع المدد الزمنية إلى أن تضخم اللثة يظهر عادةً بعد التعرض المطول لحاصرات قنوات الكالسيوم (معظم الحالات بين سنة وخمس سنوات). ورغم أن نسبة كبيرة من الحالات حدثت عند جرعات يومية منخفضة (≤ 5 ملغ/يوم)، والتي تتوافق مع الجرعات الشائعة الاستخدام من أملوديبين، إلا أن التباين في الإبلاغ عن الجرعات ووجود أدوية متعددة في بعض التقارير يحد من إمكانية استخلاص استنتاجات قاطعة حول وجود علاقة مباشرة بين الجرعة والاستجابة. لذلك، في حين يبدو أن التعرض المزمن عامل خطر ثابت، فإن التوصل إلى استنتاجات قاطعة بشأن تأثير الجرعة يتطلب بيانات أكثر دقة على مستوى المرضى. رامي الصغير - تنسيق المهام، والتحقق من البيانات، وأساليب معالجة النصوص، والملخص، وقسم المدة والجرعة، وتنسيق مستند Word. نورة الملوحي - مقدمة برنامج Word، ساهمت في إدخال البيانات وتحليل الدراسة. براء أبو سعيد - تحليل البيانات والملخصات السردية من الدراسات وكلمة الجنس والمخدرات معتز درويش - تحليل البيانات والملخصات السردية من الدراسات، المخدرات اللفظية باسل جوهرة - تحليل البيانات والملخصات السردية من الدراسات، عصر الكلمة دامدوم م، فارما إس آر، نامبيار م، فينوجوبال أ. تضخم اللثة الناجم عن حاصرات قنوات الكالسيوم: مراجعة شاملة من منظور طب الأسنان. PMCID: PMC9369783. PMID: 35966914. متاح على الرابط: https://PMC.NCBI.NLM.NIH.GOV/ARTICLES/PMC9369783/ جوبالز، جوزيف ر.، سانثوش ف.س.، هاريش كومار ف.ف.، جوزيف س.، شيتي أ.ر. انتشار تضخم اللثة الناجم عن أدوية خفض ضغط الدم: دراسة مستندة إلى المستشفى. PMCID: PMC4520117. PMID: 26229273. متاح على الرابط: https://PMC.NCBI.NLM.NIH.GOV/ARTICLES/PMC4520117/ كوراتالا أ، جمالبور الأول، موغيلي إتش آر. توسيع اللثة الناجم عن أملوديبين. بمكيد: PMC5628204. بميد: 29026579. متاح من: https://PMC.NCBI.NLM.NIH.GOV/ARTICLES/PMC5628204/ مايناس جي، سانتاماريا بي، زهير إن، اللمري إم إم، هيوز إف، لو إي إم-سي، نيبالي إل. العلاقة بين حاصرات قنوات الكالسيوم وتضخم اللثة: دراسة حالة وضابطة. متاح على الرابط: https://DOI.ORG/10.1016/J.JDENT.2024.105315؛ https://WWW.SCIENCEDIRECT.COM/SCIENCE/ARTICLE/PII/S0300571224004846 ميسرا إس آر، لاكشمي إس كيه، موهانتي إن. تضخم اللثة الناتج عن أملوديبين. PMCID: PMC8336180. PMID: 34344660. متاح على الرابط: https://PMC.NCBI.NLM.NIH.GOV/ARTICLES/PMC8336180/ بريادارشيني غاغ، إدسور إي، ساجيش إس، نيها ك، غانغادار آر. تضخم اللثة الناتج عن حاصرات قنوات الكالسيوم: سلسلة حالات. PMCID: PMC10466632. PMID: 37654362. متاح على الرابط: https://PMC.NCBI.NLM.NIH.GOV/ARTICLES/PMC10466632/ سبيروني إس، جيوفري إم، تورا تي، الجواهري كيو إيه، أنتونيلي إل، كوكولوتو إل، وآخرون. تضخم اللثة الناجم عن مضادات الكالسيوم: تقرير حالة ومراجعة للأدبيات. حرره مارتينيز-غونزاليس جيه إم. PMCID: PMC11816428. PMID: 39941250 . متاح على الرابط: https://PMC.NCBI.NLM.NIH.GOV/ARTICLES/PMC11816428/ Information & Authors Information Version history V1 Version 1 08 January 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords amlodipine overdose gingiva gingival overgrowth hypertension nifedipine Authors Affiliations Moataz darweesh 0009-0002-3702-2994 [email protected] View all articles by this author Baraa Abusaaid View all articles by this author Basel Jawhara View all articles by this author Rami Alsaghir View all articles by this author Noora Almallouhi View all articles by this author Metrics & Citations Metrics Article Usage 328 views 56 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Moataz darweesh, Baraa Abusaaid, Basel Jawhara, et al. Factors Influencing Gingival Overgrowth in Patients on Amlodipine and Nifedipine: A Systematic Review. Authorea . 08 January 2026. DOI: https://doi.org/10.22541/au.176790826.67329655/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. 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