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- What are calcium channel blockers and how do they work?
- What calcium channel blockers are available?
- Are there any differences among calcium channel blockers?
- For what conditions are calcium channel blockers used?
- What are the side effects of calcium channel blockers?
- Which drugs interact with calcium channel blockers?
What are calcium channel blockers and how do they work?
In order to pump blood, the heart needs oxygen. The harder the heart works, the more oxygen it requires. Angina (heart pain) occurs when the supply of oxygen to the heart is inadequate for the amount of work that the heart must do. By dilating the arteries, calcium channel blockers or CCBs reduce the pressure in the arteries. This makes 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. Calcium channel blockers also are used for treating high blood pressure because of their blood pressure-lowering effects. Calcium channel blockers decrease the excitability of heart muscle and are therefore used for treating certain types of abnormally rapid heart rhythms.
What calcium channel blockers are available?
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)
Discontinued brands in the US:
Are there any differences among calcium channel blockers?
Calcium channel blockers differ in their duration of action, the process by which they are eliminated from the body, and, most importantly, in their ability to affect heart rate and contraction. Some calcium channel blockers (for example, amlodipine [Norvasc]) have very little effect on heart rate and contraction so they are safer to use in individuals who have heart failure or bradycardia (a slow heart rate). Verapamil (Calan, Isoptin) and diltiazem (Cardizem) have the greatest effects on the heart and reduce the strength and rate of contraction. Therefore, they are used in reducing heart rate when the heart is beating too fast.
For what conditions are calcium channel blockers used?
Calcium channel blockers are used for treating:
- High blood pressure
- Abnormal heart rhythms (for example, atrial fibrillation, and paroxysmal supraventricular tachycardia)
Calcium channel blockers are as effective as ACE inhibitors in reducing blood pressure, but they may not be as effective as ACE inhibitors in preventing the kidney failure caused by high blood pressure or diabetes.
Calcium channel blockers may be more effective for people of African descent than other blood pressure medications.
They also are used for treating:
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What are the side effects of calcium channel blockers?
The most common side effects of calcium channel blockers are:
- Edema (swelling of the legs and feet with fluid)
- Pulmonary edema
- Low blood pressure
- Muscle weakness
- Muscle cramps
- Abnormal heartbeats
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.
Which drugs interact with calcium channel blockers?
Calcium channel blockers interact 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.
Calcium channel blockers (CCBs) are a class of drugs that dilate the arteries, and are used for treating high blood pressure, abnormally rapid heart rhythms, pulmonary hypertension, Raynaud's syndrome, cardiomyopathy, and subarachnoid hemorrhage. Calcium channel blockers also are prescribed for the prevention of migraine headaches and angina, and may also be prescribed after a heart attack.
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Kidney (Renal) Failure
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones.Treatment options included diet, medications, or dialysis.
The First Signs of Kidney Stones (Nephrolithiasis)
Kidney stones are solid masses of crystalline material that form in the kidneys. Symptoms of kidney stones can include pain, nausea, vomiting, and even fever and chills. Kidney stones are diagnosed via CT scans and specialized X-rays. Treatment of kidney stones involves drinking lots of fluids and taking over-the-counter pain medications to medical intervention including prescription medications, lithotripsy, and sometimes even surgery.
Congestive Heart Failure (CHF)
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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Mitral Valve Prolapse
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Atrial Fibrillation (AFib)
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Migraine and Stroke
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Hypertensive Kidney Disease
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Heart Attack Treatment
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Diabetes and Kidney Disease
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