- A Visual Guide to Heart Disease
- Medical Illustrations of the Heart Image Collection
- Take the Heart Disease Quiz!
- What is the Difference Between Beta Blockers and Calcium Channel Blockers?
- What Are Beta Blockers and Calcium Channel Blockers?
- What Are the Side Effects of Beta Blockers vs. Calcium Channel Blockers?
- What Drugs Interact with Beta Blockers and Calcium Channel Blockers?
- What Are the Different Types of Beta Blockers and Calcium Channel Blockers?
What is the Difference Between Beta Blockers and Calcium Channel Blockers?
- Beta blockers and calcium channel blockers are used to treat angina (chest pain), high blood pressure, and abnormal heart rhythms, and to prevent migraine headaches.
- Examples of beta blockers include acebutolol (Sectral), atenolol (Tenormin), betaxolol (Kerlone, Betoptic S), bisoprolol fumarate (Zebeta), carvedilol (Coreg), esmolol (Brevibloc), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), nebivolol (Bystolic), penbutolol (Levatol), propranolol (Hemangeol, Inderal LA, Inderal XL, InnoPran XL), sotalol (Betapace, Sorine), and timolol ophthalmic (Timoptic, Betimol, Istalol).
- Examples of calcium channel blockers include amlodipine (Norvasc), amlodipine and atorvastatin (Caduet), amlodipine and benazepril (Lotrel), amlodipine and valsartan (Exforge), amlodipine and telmisartan (Twynsta), amlodipine and olmesartan (Azor), amlodipine and olmesartan and hydroclorothiazide (Tribenzor), amlodipine and aliskiren and hydroclorothiazide, amlodipine and perindopril (Prestalia), clevidipine (Cleviprex), diltiazem (Cardizem), felodipine (Cardene, Cardene SR), isradipine, nicardipine, nimodipine, nisoldipine (Sular), and verapamil (Calan).
- Side effects of beta blockers and calcium channel blockers that are similar include nausea, rash, and sexual dysfunction.
- Side effects of beta blockers that are different from calcium channel blockers include diarrhea, stomach cramps, vomiting, blurred vision, disorientation, insomnia, hair loss, weakness, muscle cramps, and fatigue.
- Side effects of calcium channel blockers that are different from beta blockers include constipation, headache, edema (swelling of the legs and feet), low blood pressure, drowsiness, dizziness, liver dysfunction, and over growth of the gums.
- Sudden withdrawal from beta blockers may worsen angina (chest pain) and cause heart attacks, serious abnormal heart rhythms, or sudden death.
What Are Beta Blockers and Calcium Channel Blockers?
Beta blockers, also called beta adrenergic blocking agents, block the neurotransmitters norepinephrine and epinephrine (adrenaline) from binding to beta receptors on nerves, which can reduce the heart rate and reduce blood pressure by dilating blood vessels. Beta blockers are used to treat high blood pressure, heart failure, angina (chest pain), abnormal heart rhythms, tremors, pheochromocytoma, hypertrophic subaortic stenosis, migraine headache prevention, hyperthyroidism, akathisia (restlessness or inability to sit still), panic disorder, anxiety, eye pressure caused by glaucoma, and aggressive behavior. Beta blockers can also prevent further heart attacks and death after a heart attack.
Calcium channel blockers (CCBs) dilate the arteries, reducing pressure within and making it easier for the heart to pump blood, and, as a result, the heart needs less oxygen. By reducing the heart's need for oxygen, calcium channel blockers relieve or prevent angina (chest pain). Calcium channel blockers also are used for treating high blood pressure, certain types of abnormally rapid heart rhythms, pulmonary hypertension, Raynaud's syndrome, cardiomyopathy, subarachnoid hemorrhage, and to prevent migraine headaches.
What Are the Side Effects of Beta Blockers vs. Calcium Channel Blockers?
Beta blockers may cause:
Other important side effects include:
As an extension of their beneficial effect, they slow heart rate and reduce blood pressure, but they may cause adverse effects such as heart failure or heart block in patients with heart problems.
Beta blockers should not be withdrawn suddenly because sudden withdrawal may worsen angina (chest pain) and cause heart attacks, serious abnormal heart rhythms, or sudden death.
Central nervous system effects of beta blockers include:
Beta blockers that block β2 receptors may cause shortness of breath in asthmatics.
As with other drugs used for treating high blood pressure, sexual dysfunction may occur.
Other serious side effects of beta-blockers include:
- Toxic epidermal necrolysis
- Raynaud's phenomenon
- Lupus erythematosus
- Serious allergic reactions
- Erythema multiform
- Steven Johnson Syndrome
Calcium Channel Blockers
The most common side effects of calcium channel blockers are:
- Edema (swelling of the legs and feet with fluid)
- Low blood pressure
Liver dysfunction and over growth of the gums also occurs.
When diltiazem (Cardizem) or verapamil (Calan, Isoptin) are given to individuals with heart failure, symptoms of heart failure may worsen because these drugs reduce the ability of the heart to pump blood.
Like other blood pressure medications, calcium channel blockers are associated with sexual dysfunction.
What Drugs Interact with Beta Blockers and Calcium Channel Blockers?
- Combining propranolol (Inderal) or pindolol (Visken) with thioridazine (Mellaril) or chlorpromazine (Thorazine) may result in low blood pressure (hypotension) and abnormal heart rhythms because the drugs interfere with each other's elimination and result in increased levels of the drugs.
- Dangerous elevations in blood pressure may occur when clonidine (Catapres) is combined with a beta blocker, or when clonidine or beta blocker is discontinued after their concurrent use. Blood pressure should be closely monitored after initiation or discontinuation of clonidine or a beta blocker when they have been used together.
- Phenobarbital and similar agents may increase the breakdown and reduce blood levels of propanolol (Inderal) or metoprolol (Lopressor, Toprol XL). This may reduce effectiveness of the beta blocker.
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) (for example, ibuprofen) may counteract the blood pressure reducing effects of beta blockers by reducing the effects of prostaglandins, which play a role in control of blood pressure.
- Beta blockers may prolong hypoglycemia (low blood sugar) and mask symptoms of hypoglycemia in diabetics who are taking insulin or other diabetic medications.
Calcium Channel Blockers
Most of the interactions of calcium channel blockers 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 blood 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 calcium channel blockers.
What Are the Different Types of Beta Blockers and Calcium Channel Blockers?
- acebutolol (Sectral)
- atenolol (Tenormin)
- betaxolol (Kerlone)
- betaxolol (Betoptic S)
- bisoprolol fumarate (Zebeta)
- carteolol (Cartrol, discontinued)
- carvedilol (Coreg)
- esmolol (Brevibloc)
- labetalol (Trandate [Normodyne - discontinued])
- metoprolol (Lopressor, Toprol XL)
- nadolol (Corgard)
- nebivolol (Bystolic)
- penbutolol (Levatol)
- pindolol (Visken, discontinued)
- propranolol (Hemangeol, Inderal LA, Inderal XL, InnoPran XL)
- sotalol (Betapace, Sorine)
- timolol (Blocadren, discontinued)
- timolol ophthalmic solution (Timoptic, Betimol, Istalol)
Calcium Channel Blockers
The calcium channel blockers that have been approved for use in the US include:
- amlodipine (Norvasc)
- amlodipine and atorvastatin (Caduet)
- amlodipine and benazepril (Lotrel)
- amlodipine and valsartan (Exforge)
- amlodipine and telmisartan (Twynsta)
- amlodipine and olmesartan (Azor)
- amlodipine and olmesartan and hydroclorothiazide (Tribenzor)
- amlodipine and aliskiren and hydroclorothiazide
- amlodipine and perindopril (Prestalia)
- clevidipine (Cleviprex)
- diltiazem (Cardizem)
- felodipine (Cardene, Cardene SR)
- nisoldipine (Sular)
- verapamil (Calan)
Beta blockers and calcium channel blockers are used to treat angina (chest pain), high blood pressure, and abnormal heart rhythms, and to prevent migraine headaches. Beta blockers and Calcium channel blockers (CCBs) both dilate the blood vessels through different mechanisms, reducing pressure within and making it easier for the heart to pump blood.
Multimedia: Slideshows, Images & Quizzes
High Blood Pressure (Hypertension) Quiz: Symptoms, Signs & Causes
Take this quiz and test your IQ of high blood pressure (hypertension), the cardiovascular disease that causes most strokes and...
Picture of Blood Pressure
The blood pressure is the pressure of the blood within the arteries. See a picture of Blood Pressure and learn more about the...
How to Lower Blood Pressure: Exercise Tips
Trying to lower high blood pressure (hypertension)? Discover exercises good for lowering blood pressure, along with other...
Migraine or Headache? Migraine Symptoms, Triggers, Treatment
What does a migraine feel like? Discover the difference between headaches and migraines. Learn to spot migraine symptoms early,...
High Blood Pressure (Hypertension): Symptoms, Causes, Treatments
What causes high blood pressure (hypertension)? Know the warning signs and symptoms of high blood pressure. Read about high blood...
Related Disease Conditions
Angina (Symptoms, Causes, Types, Diagnosis, and Treatment)
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning,...
High Blood Pressure (Hypertension) Signs, Causes, Diet, and Treatment
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million...
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on...
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include...
Atrial Fibrillation (AFib) Treatment Drugs
Atrial fibrillation (also called Afib or Afib) is heart rhythm disorder that causes irregular, and often, a rapid heartbeat. The...
Treatment & Diagnosis
- High Blood Pressure FAQs
- High Blood Pressure and Exercise
- Blood Pressure Guidelines
- Beta Blockers: Why Take a Beta Blocker?
- Beta Blockers May Decrease Heart Complications Of Surgery
- Inherited High Blood Pressure in a Teenager
- Hypertension In The Elderly - Deserves More Attention
- Salt, DASH, High Blood Pressure
- Angina: Don't Take It Lightly
- How Long Does Herpangina Last in Children?
- What Does Hypertension Urgency Mean?
- What Is the Difference Between ACE Inhibitors and A Beta Blockers?
- Can Blood Pressure Make Gout Worse?
- Can I Still Get Heart Disease if I Take Blood Pressure Medication?
- Do I Have Angina?
- Can I Lift Weights with High Blood Pressure?
- Can Stress Cause Low Blood Pressure?
- Can I Still Exercise With Low Blood Pressure?
- Angina Diagnosis
- High Blood Pressure Symptoms
- Angina Symptoms
- Lowering Blood Pressure: It's a 2-Step Process
- Heart Healthy Diet: Hypertension & Heart Disease
Medications & Supplements
- betaxolol suspension - ophthalmic, Betoptic S
- timolol solution-gel - ophthalmic, Timoptic-XE
- labetalol - oral, Normodyne, Trandate
- amlodipine/benazepril - oral, Lotrel
- carvedilol - oral, Coreg
- atenolol - oral, Tenormin
- timolol/dorzolamide drops - ophthalmic, Cosopt
- amlodipine - oral, Norvasc
- timolol (Blocadren and Timolide 10-25 have been discontinued)
- Lotrel (amlodipine and benazepril)
- amlodipine, Norvasc
- Sectral (acebutolol)
- atenolol, Tenormin
- timolol ophthalmic solution (Timoptic, Timoptic-XE, Timoptic in Ocudose)
- atenolol and chlorthalidone, Tenoretic
- betaxolol, Kerlone (Discontinued Brand)
- betaxolol ophthalmic, Betoptic S, Betoptic
- carvedilol (Coreg, Coreg CR)
- labetalol, Normodyne, Trandate
- amlodipine/atorvastatin - oral, Caduet
- sotalol, Betapace, Betapace AF, Sorine, Sotylize
- isradipine - oral, Dynacirc
- nimodipine - oral, Nymalize
- amlodipine and valsartan (Exforge)
Latest High Blood Pressure News
Daily Health News
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.