CALCIUM CHANNEL BLOCKERS

CHEMICAL NAME BRAND NAME(S)
AMLODIPINE CADUET (in combination with the cholesterol medicine ATORVASTATIN), NORVASC, LOTREL (in combination with the ACE inbibitor BENAZEPRIL)
BEPRIDIL VASCOR
DILTIAZEM CARDIZEM, CARTIA, DILACOR, DILTIA, TIAMATE, TIAZAC, TECZEM (in combination with the ACE inbibitor ENALAPRIL)
FELODIPINE PLENDIL, LEXXEL (in combination with the ACE inbibitor ENALAPRIL)
ISRADAPINE DYNACIRC
MIBEFRADIL* POSICOR*
NICARDIPINE CARDENE
NIFEDIPINE ADALAT, NIFEDICAL, PROCARDIA
NIMODIPINE NIMOTOP
NISOLDIPINE SULAR
VERAPAMIL CALAN, COVERA-HS,  ISOPTIN, VERELAN, TARKA (in combination with the ACE inbibitor TRANDOLAPRIL)

*Voluntarily withdrawn from market by manufacturer.

USES OF CALCIUM CHANNEL BLOCKERS

Movement of calcium ions across cell membranes is crucial to the functioning of muscle in the heart and blood vessels as well as the electrical conduction system of the heart.

Calcium Channel Blockers (CCBs) , as the name implies, block the influx of calcium into cells. This relaxes the muscle in the walls of arteries, resulting in dilation of arteries. This, in turn, lowers the blood pressure and improves the blood supply to the heart. They also relax the heart muscle. All of these effects allow the heart to make do with a reduced blood supply and help treat the symptoms of angina.

Some CCBs (diltiazem, mibefradil, verapamil) slow the heart rate, which further helps to control angina. Diltiazem and verapamil are also helpful in controlling abnormally fast heart rhythms.

Bepridil can cause abnormal heart rhythms and use is reserved for people with angina who have exhausted other treatment options.

The most common side effect from verapamil is constipation.

Side effects from diltiazem are quite rare.

The most common side effects of the others include dizziness, flushing, headaches and swelling of the ankles. The exact incidence depends on which CCB is used. In most people, they are well tolerated.

Some time ago, there were reports that use of CCBs in high blood pressure patients may increase the risk of a heart attack. Those studies suffered from methodological flaws. There is no clear evidence that these medicines are dangerous if used properly.

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