by Swollen ankles are a common side effect of many medications. While the swelling may not be harmful in and of itself however, it can signal that you’re experiencing an adverse reaction to the drug, which can worry some individuals. In this article, we will highlight what medications can cause swollen ankles. Read on to find out more!
Diabetes Medications
Some medications for diabetes can cause swollen ankles as a side effect. This is because these drugs often cause fluid retention, leading to swelling and puffiness in the extremities. Rosiglitazone and pioglitazone are the two main culprits here.
These groups of medications are called thiazolidinediones. The mechanism of action that causes fluid overload is not properly understood. It is believed that peroxisome proliferator-activated receptor gamma (PPAR-gamma) stimulates sodium reabsorption leading to fluid retention (1).
Calcium channel blockers
Calcium channel blockers are medications used to treat high blood pressure and heart disease. These drugs work by relaxing the blood vessels. That is, they reduce the amount of calcium entering the heart, which in turn lowers blood pressure. However, one of the side effects of calcium channel blockers is fluid retention, which can cause the ankles to swell.
The most common calcium channel blockers that cause this problem are nifedipine, amlodipine and felodipine. They fall under the class of dihydropyridines. Serious side effects are rare. Nevertheless, if you have swollen ankles while taking any of these medications, see your doctor, as they may be able to prescribe a different drug.
Beta-blockers
Beta-blockers are used to treat high blood pressure and heart conditions. They work by blocking the effects of adrenaline and lowering blood pressure. Beta-blockers are also sometimes used to treat anxiety.
Like calcium channel blockers, beta-blockers can cause fluid retention and swollen ankles as a side effect. The most common beta-blockers that cause this problem are bisoprolol, propranolol and metoprolol. Side effects can include but are not limited to difficulty falling asleep, nightmares and depression.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are used to treat pain and inflammation. They work by reducing prostaglandins levels, hormones that play a role in pain and inflammation modulation. However, one of the side effects of NSAIDs is sodium reabsorption and fluid retention (2). Which again, can lead to swollen ankles.
The most common NSAIDs that cause this problem are ibuprofen, naproxen and diclofenac. Side effects can include stomach pain, heartburn and indigestion. NSAIDs should not be used for extended periods of time. It may be necessary to speak to your physician about alternatives if you have to be on them for long periods.
Hormone drugs
Hormone replacement therapy (HRT) is a type of medication used to treat the symptoms of menopause. It works by replacing the hormones that are no longer produced by the ovaries. However, one of the side effects of HRT is fluid retention, which can also lead to swollen ankles.
The most common hormone drugs that cause this problem are oestrogen and progesterone. Side effects include but are not limited to weight gain, nausea and breast tenderness. If you have swollen ankles while taking HRT and are worried about it, your doctor may be able to prescribe a different drug, so it’s worth chatting with them.
Antidepressants
Antidepressants are medications used to treat depression and sometimes neurological pain. They work by correcting the chemical imbalance in the brain that is thought to cause depression. Many people on antidepressants suffer from the side effect of fluid retention.
The most common antidepressants that cause this problem are fluoxetine, sertraline and paroxetine. Some side effects that can occur include weight gain, dry mouth and blurred vision. If you are suffering from depression and are on the medications mentioned above and have developed swollen ankles, it’s not advisable to stop taking your medication. Instead, speak to your physician regarding alternatives.
Steroids
Steroids are used to treat various conditions, including inflammation, allergies and asthma. They work by reducing the levels of inflammation-promoting hormones in the body. One side effect of steroids is also fluid retention.
The most common steroids that cause this problem are prednisone and dexamethasone. Other side effects can include weight gain, acne, difficulty sleeping, anxiety and mood swings.
Seizure medications
Seizure medications are used to treat epilepsy, and they work by correcting the chemical imbalance in the brain that is thought to cause seizures. Again, these medications can cause fluid retention and yes can lead to swollen ankles.
Phenytoin and carbamazepine are the two most common medications that cause this problem. Other side effects include drowsiness, dizziness and confusion.
Parkinson’s drugs
Parkinson’s drugs work by correcting the brain’s chemical imbalance. Also, they can lead to fluid retention, and cause swollen ankles.
The two most common drugs that cause this problem are levodopa and carbidopa. Side effects include nausea, vomiting and dizziness. Currently, there is no cure for Parkinson’s disease, so you should not stop taking your medications unless you have spoken to your consultant.
Cancer drugs
Cancer drugs fight cancer by interfering with the growth and reproduction of cancer cells. Some cancer drugs can cause fluid retention and swollen ankles. The most common cancer drugs causing this problem are doxorubicin and vincristine. Other side effects include hair loss, nausea and fatigue. With that said, if you are experiencing swollen ankles, you must speak to your doctor before stopping your medication. Additionally, wearing appropriately fitting shoes, reducing salt intake and doing exercises (If you can) will help reduce the swelling.
Treatment for swollen ankles
Fluid retention can be treated with thiazide, loop and potassium-sparing diuretics medications. They work by removing excess fluid from the body. Common thizide diuretic include but are not limited to hydrochlorothiazide, chlorthalidone and methyclothiazide. Loop diuretics include furosemide, bumetanide and ethacrynic. Potassium-sparing diuretics include eplerenone, amiloride, and spironolactone.
Side effects of these drugs can include dehydration, electrolyte imbalance and dizziness. If you have swollen ankles and are unsure of the cause, it’s always best to speak to a medical professional for advice.
Things you can do to help ease the symptoms If you are suffering from swollen ankles include:
- Rest with your feet up: this will help reduce the swelling.
- Wear loose-fitting clothing: tight clothing can make the swelling worse.
- Exercise: this will help to increase circulation and reduce swelling.
- Wear appropriate-fitting shoes.
Questions your doctor may ask if you are on medications and suffering from swollen ankles
To diagnose the cause of your swollen ankle, your doctor may ask you the following questions:
- When did you first notice the swelling?
- Is the swelling worse at certain times of the day?
- Have you recently changed your medication?
- Do you have any other symptoms?
- Do you have a history of heart disease or kidney disease?
- Do you have a history of diabetes?
- Do you have a family history of any medical conditions?
Based on your response to the questions, your doctor may also order some tests, such as blood tests or an MRI, to rule out other causes of your swollen ankle.
Questions to ask our doctor
If you are still unsure are concerned, you may want to ask your doctor the following questions to help allay your fears:
- What is the most likely cause of my swollen ankle?
- Are there any other potential causes of my swollen ankle?
- What other tests do I need to have done?
- How can I treat my swollen ankle?
- When will my symptoms improve?
- What can I do to prevent my symptoms from getting worse?
- Is there anything else I need to know about my condition?
Prognosis
Most cases of swollen ankles due to fluid retention will improve with treatment. However, the swelling may come back if the underlying cause is not treated. In some cases, such as when the reason is heart failure, the prognosis may be more serious. Speak to your doctor about your specific condition and what you can expect.
Conclusion
These are just some of the medications that can cause swollen ankles. While swollen ankles can be a nuisance, they are not serious in most cases. As such, They will resolve on their own once the underlying cause is dealt with. However, you should take it seriously and seek help by speaking to your physician. Your health is your wealth!
