3. CONCLUSION
Many drugs are accountable, through different mechanisms, for peripheral
edema. Severity is distinctly variable ranging from slight edema of the
lower limbs to anasarca pictures as in capillary leak syndrome. Although
most often pitting and bilateral, some drugs are associated with
peripheral edema that is readily erythematous (e.g., dopaminergic
agonists, pemetrexed) or unilateral (e.g., sirolimus). Apart from
calcium channel blockers, drug-induced peripheral edema is
underrecognized and misdiagnosed, frequently leading to a prescribing
cascade. Four main mechanisms are involved, namely precapillary
arteriolar vasodilation (vasodilatory edema), sodium/water retention
(renal edema), lymphatic insufficiency (lymphedema) and increased
capillary permeability (permeability edema).