AMLODIPINE INDUCED PETECHIAL RASH, COLD AND COUGH IN BREASTFEEDING YOUNG LADY-A CASE REPORT

Eva Lorel Kouassi* and Sheethal Kuriakose

ABSTRACT

Introduction: Amlodipine is a calcium channel blocker that is widely used in mild to moderate hypertension, chronic stable angina and vasospastic angina. Although many studies have reported its association with remarkable complications such as peripheral edema, flushing and headache, hypersensitivity reactions, cold and cough remain rare adverse reactions of this drug. Case report: This study presents a case of a 29 year old female lady with 38 weeks period of gestation. She was diagnosed with gestational hypertension 6 months ago for which antihypertensive (tablet nifedipine and labetalol) were prescribed. She was stabilized on 5 mg amlodipine once daily after which she developed cold, brownish black petechial rash over her neck and hands. History, clinical examinations and lab investigations revealed no abnormalities. The patient denied any previous use of medications other than the ones prescribed; consequently the diagnosis made was a diagnosis by exclusion. WHO ADR causality assessment was performed which placed this reaction as a probable adverse reaction to amlodipine. Hence the dose of amlodipine was decreased to 2.5 mg and lastly stopped. The rash resolved gradually over a period of three weeks. Discussion: The petechial rash experienced by the patient can mainly be explained by the increased hydrostatic pressure. The best management provided was withdrawal of the responsible drug. Conclusion: Amlodipine-induced cough; cold and petechial rash is a rare and cosmetically disagreeable adverse reaction which requires profound study for better understanding and management. This case highlights the necessity of rational drug use in vulnerable population like breastfeeding ladies.

Keywords: amlodipine, petechial rashes, cold.