Calcium Channel Blockers in Clinical Use for Ischemic Heart Disease

Calcium Channel Blockers in Clinical Use for Ischemic Heart Disease

Drugs Usual Dose Duration of Action Side Effects Dihydropyridines  Amlodipine 5–10 mg qd Long Headache, edema Felodipine 5–10 mg qd Long Headache, edema Isradipine 2.5–10 mg bid Medium Headache, fatigue Nicardipine 20–40 mg tid Short Headache, dizziness, flushing, edema Nifedipine Immediate release:a 30–90 mg/d orally Short Hypotension, dizziness, flushing, nausea, constipation, edema Slow release: 30–180 mg orally Nisoldipine 20–40 mg qd Short Similar to nifedipine Nondihydropyridines  Diltiazem Immediate release: 30–80 mg 4 times daily Short Hypotension, dizziness, flushing, bradycardia, edema Slow release: 120–320 mg qd Long Verapamil Immediate release: 80–160 mg tid Short Hypotension, myocardial depression, heart failure, edema, bradycardia Slow release: 120–480 mg qd Long

Note: This list of calcium channel blockers that may be used to treat patients with angina pectoris is divided into two broad classes, dihydropyridines and nondihydropyridines, and arranged alphabetically within each class. Among the dihydropyridines, the greatest clinical experience has been obtained with amlodipine and nifedipine. After the initial period of dose titration with a short-acting formulation, it is preferable to switch to a sustained release formulation that may be taken once daily to improve patient compliance with the regimen. aMay be associated with increased risk of mortality if administered during acute myocardial infarction. Source: Modified from RJ Gibbons et al.