What is Amlodipine Besylate?

Amlodipine besylate is surely one of the drugs most prescribed to hypertensive patients as well as those experiencing chest pain or angina. It comes under calcium channel blockers that create an end to the pressure in the blood vessels to increase the flow in the bloodstream. This medicine may be used with other prescribed medications to control high blood pressure. Therefore, the drug controls angina by preventing enough oxygen-rich blood from reaching the heart muscle. Thus, it relieves symptoms of chest pain.
Amlodipine besylate is the formulation of Amlodipine that combines the salt besylate, increasing the drug’s absorption and making the pharmacologically lively version of the medication. Despite dropping blood pressure very efficiently, there have always been concerns about the predisposition of the patient to having high sugar levels in the blood that, in a few cases, may even result in the diagnosis of Diabetes. In this blog, we will discuss Can Amlodipine Besylate cause Diabetes.

How does it work?

This is a calcium antagonist. A calcium channel blocker allows calcium entry into the blood vessel wall cells. Calcium is an important ion in muscle contraction. Amlodipine decreases blood pressure because it cannot lead to calcium entering the cell inside the blood vessel walls as it blocks the effect of increased resistance in the blood vessels.

Side effects of Amlodipine

It may cause side effects. Consult your doctor if you have any of the symptoms given below.

• nausea
• stomach pain
• dizziness or lightheadedness
• drowsiness
• excessive tiredness
• flushing
• swelling of the hands, feet, ankles, or lower legs
• muscle stiffness or tremors

Can Amlodipine Cause High Blood Sugar or Diabetes?

Though this is seldom the case, there have been recorded instances wherein it brought about hyperglycemia in patients. It occurs when the body fails to produce or manufacture enough insulin or when the insulin is not that effective in the body. It leads to the development of type 2 diabetes if it is not treated well.
Although the link is not as well established as with thiazide diuretics and beta-blockers, whose association with hyperglycemia is well documented, it has been reported in the literature to affect insulin release by blocking Ca2+ activity in the pancreas and to increase blood sugar levels over time.

Studies on Amlodipine and Diabetes Risk

Other research has involved studies on the class of antihypertensive drugs and their associations with the incidence of Diabetes. Perhaps one of the most significant studies in this regard is the ALLHAT trial, comparing how different blood pressure medications might influence the risk of developing Diabetes. In this study, researchers found that the diuretic chlorthalidone was linked to a significantly higher rate of hyperglycemia and new-onset sugar than Amlodipine or Lisinopril. They also concluded that ACE inhibitors, particularly Lisinopril, posed the lowest risk of developing sugar.
On the other hand, though, another clinical trial research titled the VALUE trial revealed that patients on besylate had greater risks of Diabetes than those with valsartan, which is an ARB.
Although the risk is low, this research indicates that in predisposed patients, one of the contributing factors is its potential to trigger the onset of blood sugar.

Case Report: Amlodipine-Induced Hyperglycemia

There is a probable connection between Amlodipine and diabetes mellitus, based on the recent case report. A 57-year-old woman was administered 5 mg/day of Amlodipine besylate for hypertension. At the end of the third week, she developed symptoms of hyperglycemia that manifested with polydipsia, polyuria, and distortion of vision. She had Diabetes as the blood test reported that the fasting blood sugar level was 305 mg/dL and an HbA1c of 9.1 %, which exceeds the threshold for the disease.
Never had a history of hyperglycemia before initiation with Amlodipine. The doctor instructed her to stop the Amlodipine and put her on an alternative antihypertensive. In addition, she changed some lifestyle habits; she reduced soda and other sugar-sweetened beverages consumption and increased her consumption of vegetables. That is impressive since her blood glucose normalized over the weeks following the discontinuation of amlodipine therapy. Therefore, she was ruled out of the diagnosis of Diabetes. After three months, HbA1C came down to 5%, and she was maintained on no medication for it.
This case suggests that Amlodipine was the causative agent in this patient’s developing hyperglycemia. The reader cannot surmise how this is possible other than what the mechanism whereby Amlodipine besylate works as a calcium blocker interferes with insulin release, thereby increasing blood sugars. The fact that rapid resolution of hyperglycemia followed after the discontinuation of the drug supports the hypothesis that may have been the offending agent.

Implications for Patients and Healthcare Providers

Although this risk is very low, the actual cause of Diabetes by the drug should be clear to the patient as well as to other healthcare providers. Patients taking Amlodipine besylate should regularly check their blood sugar levels, especially if they experience symptoms like thirst, increased urination, or blurred and double vision.
Healthcare providers should be aware of the risks of hyperglycemia when prescribing Amlodipine, especially among patients with more significant risk profiles for Diabetes. These would be individuals who have family histories of Diabetes, are obese or carry other risk factors for metabolic disorders. In such cases, healthcare providers should initiate blood sugar monitoring immediately to detect early signs of hyperglycemia.

Conclusion:

Like other drugs, amlodipine besylate also had a potential for risk and side effects. However, hyperglycemia from using Amlodipine is reported to occur very rarely. The case report mentioned above suggests that patients prescribed this drug should regularly undergo examinations to ensure their blood sugar levels remain within a healthy range.
Suppose you are on Amlodipine, and you suspect you may be experiencing symptoms of high sugar levels in your blood, such as excessive thirst or urination. In that case, it is going to be essential to pay a visit to your healthcare provider. For one, early detection and treatment of hyperglycemia can prevent the onset of Diabetes, while the management plan will also remain safe and effective for you. Like every drug, there is appropriate weighing of risks versus benefits for long-term health care.