What Causes Swelling In The Ankles, Feet And Hands?

Posted on Fri, 17 Jun 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 17 Jun 2016 Answered on

Fri, 8 Jul 2016 Last reviewed on

Question : I have developed swelling in my ankles, feet and hands. I also have pulseating tinitas and some nerve pain n feet. I have seen my kidney, hearing and nerve pain doctors and have had all tests(ct, ultra sound etc) There is nothing relitive to the cause of my swelling and pain. Drs say maybe poor circulation and arthritis?
Here are the meds I am taking , I have asked my family Dr if this could be the cause of my symptoms.
He said no , but I think he may be wrong. He has sent me to all these specialists costing me time amd money with out finding the answers I am looking for.
High BP, Cronic Kidney
Metoprolol ER Succinate 25 mg, Simvastatin 10mg, Amlodipine Besylate 10mg

Answered by Dr. Dr. Meriton Siqeca (16 minutes later)

Brief Answer:
Amlodipine should be taken off the therapy

Detailed Answer:
Hello and welcome to HCM. I understand your concern. Thank you for your question.

You see, besides the chronic kidney disease that may cause swollen ankles, it is also amlodipine that is well-known for this side effect, and it is found in up to 10% of patients when they take this drug regularly. What should we do? Well, as a first, if I were your doctor, I would take you off amlodipine. Do not get stressed, it may take up to one month for this side effect to subside. In the mean time, if your creatinine levels are under 2.5 mg/dL, then it is safe to introduce an angiotensiogen-converting enzyme inhibitor (ACE-I: captopril, enalapril, ramipril) to your anti-hypertensive therapy. Also, I would add a 40 mg furosemide a day, to your anti-hypertensive therapy, which is also beneficial in the chronic kidney disease terrain. Although these are merely recommendations to with what we can substitute the amlodipine, one thing is for sure: it is recommend to take it off the therapy. Also, and this is not urgent, I would recommend you to perform an echo cardiogram (sonography of the heart which helps us evaluate the heart chambers and valves by structure, motility and function). If the suggested substitutions are not recommended due to your parameters, then it is recommended to switch to an another "dipin", such as lercanidipine or nitrendipin, which rarely express this side effect of amlodipine.

I hope I was helpful with my answer. I am happy to help, if you have follow-up questions.

Best regards,
Dr. Meriton

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Above answer was peer-reviewed by : Dr. Vaishalee Punj