Comparison effectiveness, side effect and long-term tolerability of amlodipine and cilnidipine

Hypertensive patients usually benefit from selective antihypertensive medications like Calcium Channel Blockers. Amlodipine and Cilnidipine both comes under Calcium Channel Blockers.Both the drugs use widely to control hypertension. Amlodipine is a third generation CCB comes under dihydropyridine and Cilnidipiene is a (long acting dihydropyridine) fourth generation CCB. Both the drugs has an excellent pharmacokinetic and pharmacodynamic profile. Both the drugs has significant percentage of safety and tolerability but Amlodipine has a typical side effect i.e. B/L Pedal edema. Around 5-10% of the patients are suffering from B/L Pedal edema with Amlodipine therapy which can be recovered after switching to Cilnidipine therapy. CCB related edema is caused by preferential arteriolar or precapillary dilation in the venous or postcapillary circulation. Amlodipine works by demonstrate prolonged efficacy by inhibiting voltage dependent L-type calcium channel. Cilnidipine works by blocking L-type & C-type both the calcium channel. Cilnidipine's dual mechanism of action allows for effective blood pressure reduction through vascular smooth muscle relaxation & arterial dilation, while also suppressing catecholamine release from sympathetic nerves. This unique pharmacological profile may explain cilnidipine's lower incidence of adverse effects, including pedal edema.