Amlodipine use during pregnancy: Current status in the medical care field in Argentina

Abstract

Introduction: Calcium channel blockers (CCBs), such as nifedipine, are commonly used to treat hypertensive disorders of pregnancy (HDP). With the withdrawal of Nifedipine-RETARD and the limitations in compounding formulations, the off-label use of amlodipine (AML) has increased. The primary objective of this study was to describe the frequency of AML use, while the secondary objective was to outline the professional profile of the surveyed physicians.

Materials and methods: A descriptive, observational, cross-sectional study conducted in 2024 using closed digital surveys. The target population included physicians of both sexes involved in the care of HDP in Argentina, with access to electronic devices and the Internet. The survey was developed by the Working Group on Hypertension in Women of the Argentine Society of Hypertension (SAHA) and validated by experts. It was distributed through social networks and SAHA's email list.

Results: A total of 276 physicians were surveyed, with a mean age of 49.6±11.5 years, 46.6% of whom were women. Among the respondents, 213 (77.1%) used CCBs to treat HDP, and 176 (63.8%) reported prescribing AML. Of those prescribing AML, 51% were general practitioners, 12% cardiologists, 22% obstetrician-gynaecologists, and 14% belonged to other specialties. The initial dose reported was 5mg/day in 82.4% of cases. The main reasons cited for not prescribing AML were lack of experience (44.4%) and perceived insufficient scientific evidence (28.9%).

Conclusions: The use of AML was frequent, with 6 out of 10 surveyed physicians reporting its use.

Keywords: Amlodipine; Amlodipino; Antihipertensivos; Antihypertensive agents; Embarazo; Hipertensión arterial; Hypertension; Mujer; Pregnancy; Women.