Pharmacology · patient case question
Which medication in this patient's list is the most likely cause of the gingival enlargement?
Patient case: Antihypertensive Review & Gingival Enlargement
demo: 60-year-old male
chief: “My gums have been growing over my front teeth.”
history: Hypertension, benign prostatic hyperplasia, angina.
meds: Nifedipine, prazosin, terazosin, atenolol
findings: Generalized fibrotic enlargement of the interdental papillae, most marked in the anterior maxilla. Plaque index moderate. No bone loss on bitewings.
Show answer and explanation
Correct answer: A. Nifedipine
- A. Correct. Nifedipine is a dihydropyridine calcium channel blocker, and CCBs are one of the three classic drug groups causing gingival overgrowth — along with phenytoin and cyclosporine. Amlodipine does the same.
- B. Terazosin, like prazosin, is an alpha-1 blocker used for hypertension and BPH; it does not cause gingival overgrowth.
- C. Beta blockers are not associated with gingival overgrowth.
- D. Alpha-1 blockers are not associated with gingival overgrowth.
Note: The enlargement is drug-influenced, not drug-caused in isolation — plaque is a required cofactor, which is why meticulous hygiene is the first line of management before any surgical reduction.