Introduction
Calcium channel blockers are primarily used in the management of cardiovascular disease. Voltage-gated calcium channels are present in myocardial cells, cells of the conduction system and those of the vascular smooth muscle. The various types of calcium channel blockers have varying effects on these three areas and it is therefore important to differentiate their uses and actions.
| Examples | Indications & notes |
|---|---|
| Verapamil | Angina, hypertension, arrhythmias |
| Diltiazem | Angina, hypertension |
| Nifedipine, amlodipine, felodipine (dihydropyridines) | Flushing, headache, ankle swelling |
Adverse effects
| Examples | Side-effects and cautions |
|---|---|
| Verapamil | Highly negatively inotropic. Should not be given with beta-blockers as may cause heart block Heart failure, constipation, hypotension, bradycardia, flushing |
| Diltiazem | Less negatively inotropic than verapamil but caution should still be exercised when patients have heart failure or are taking beta-blockers Hypotension, bradycardia, heart failure, ankle swelling |
| Nifedipine, amlodipine, felodipine (dihydropyridines) | Flushing, headache, ankle swelling |