BACKGROUND Gingival enlargement (GE) is a frequent side effect associated with the administration of cyclosporine (CsA) and the calcium channel blockers (CCB). The aims of this study were to determine and compare GE prevalence and severity in 3 groups of renal transplant recipients who had been medicated with CsA versus CsA in combination with nifedipine versus CsA in combination with amlodipine. METHODS A cohort of 93 patients included 31 medicated with CsA, 31 with CsA plus nifedipine, and 31 with CsA plus amlodipine. The presence and severity of GE were assessed using the index developed by Harris and Ewart. RESULTS There were significant differences in GE prevalence and GE severity among the 3 groups. A greater proportion (90.3%) of the CsA-nifedipine group was categorized as having GE compared with the CsA-amlodipine group (58.1%) or the CsA group (51.6%). A greater percentage of subjects in the CsA-nifedipine group displayed severe GE (22.6%) when compared with the CsA (0%) or the CsA-amlodipine group (16.1%). CONCLUSIONS The prevalence and severity of GE in subjects maintained on CsA-nifedipine was significantly greater than that among subjects treated with CsA-amlodipine or CsA only. The GE prevalence and severity was greater in the CsA-amlodipine group than the CsA group. This observation should lead clinicians to avoid the use of these drugs together with CsA or to choose amlodipine instead of nifedipine.