With which drugs do calcium channel blockers interact?

Most of the interactions of CCBs occur with verapamil (Calan, Isoptin) or diltiazem (Cardizem). The interaction occurs because verapamil and diltiazem decrease the elimination of a number of drugs by the liver. Through this mechanism, verapamil and diltiazem may reduce the elimination and increase the blood levels of carbamazepine (Tegretol), simvastatin (Zocor), atorvastatin (Lipitor), and lovastatin (Mevacor). This can lead to toxicity from these drugs.

Grapefruit juice (approximately 200 ml) may elevate serum concentrations of felodipine (Plendil), verapamil (Calan, Isoptin), nisoldipine (Sular), nifedipine (Adalat, Procardia), nicardipine (Cardene), and possibly amlodipine (Norvasc). Grapefruit juice should not be consumed within 2 hours before or 4 hours after administration of affected CCBs.

What calcium channel blockers are available?

The CCBS that have been approved for use in the US include:

• amlodipine (Norvasc)
  
  
• clevidipine (Cleviprex)
  
  
• diltiazem (Cardizem),
  
  
• felodipine (Plendil),
  
  
• isradipine (Dynacirc),
  
  
• nifedipine (Adalat, Procardia),
  
  
• nicardipine (Cardene),
  
  
• nimodipine (Nimotop),
  
  
• nisoldipine (Sular), and
  
  
• verapamil (Calan, Isoptin).

Reference: FDA Prescribing Information

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