Thank you for your reply.
From what I understand, the biggest concern is swelling in the legs as well as enlarged breasts & decreased libido. Please correct me if I am wrong.
Amlodipine is well known to cause swelling in the legs. If swelling in the legs is considerable, then Amlodipine should be stopped. Also, one of the ways to improve swelling in the legs secondary to Amlodipine is to add another blood pressure medication which falls in the class of either Ace Inhibitors (Lisinopril, Benazapril, Ramipril) or Angiotensin Receptor Blockers (Diovan, Losartan, Benicar). When Amlodipine is given along with any of these medications, swelling is somewhat minimized.
Spironolactone is also well known to cause breast enlargement and inability to achieve an erection. It is actually one of its most common side effects. Going from 1/2 a tablet to a full tablet will only make both of these conditions worse.
I hope Mr. Hung is not receiving Spironolactone to improve his swelling (Spironolactone is a water pill) because the cause of swelling is most likely Amlodipine.
I don't know which medications have already been tried but I do work in the VA and know that if a certain drug fails to give desired benefits (in your case it would be to lower blood pressure) or to cause side effects, a non-formulary request can be placed for another agent. Some of the more common medications which I use are Metoprolol, Hydrochlorothiaizide, and Lisinopril. If these fail, my next choice of medication would be Hydralazine which is usually very effective in lowering blood pressure.
I hope I did not confuse you and that I understood your question.
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Best wishes and good luck,