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Blood Pressure Drugs - Page 7

Calcium Channel Blockers

Calcium Channel Blockers

(check with manufacturer for specific information)

Commonly prescribed brands:

Amlodipine

Diltiazem

Nifedipine

Verapamil

Felodipine

Norvasc

Tiazac

Procardia

Covera-HS

Plendil

How they are given:

  • Oral (tablet or capsule)

What they are used for:

You should not be treated with them if:

  • You have been diagnosed with:
  • Abnormally low heart rate
  • Second- or third-degree heart block (a delayed or complete lack of electrical communication between the upper chambers of the heart and the lower chambers of the heart) unless you have a pacemaker
  • Low blood pressure

Possible side effects:

  • Headaches and swelling of the ankles
  • Verapamil can cause constipation and excessive slowing of the heartbeat

Pregnancy/nursing:

  • The safety of these medications during pregnancy is unknown
  • Women who are nursing should not use calcium channel blockers; if the treatment is essential, then nursing should be discontinued

How do calcium channel blockers work?
Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels. Calcium is required for muscles to contract and for the blood vessels to narrow. Calcium channel blockers effectively widen blood vessels and decrease the strength of the heartbeat, causing blood pressure to fall.

Who should take calcium channel blockers?
In addition to treating high blood pressure, calcium channel blockers are also used to treat other heart problems including chest pain ( angina) due to heart disease or coronary spasm (see Prinzmetal’s angina), and some abnormal heart rhythms. For chest pain, calcium channel blockers are often prescribed along with nitrates.
There are two types of calcium channel blockers, and which kind you are prescribed may depend on whether you have certain heart conditions. One type (the dihydropyridines, such as amlodipine and nifedipine) does not slow the heart rate or cause other abnormal heart rhythms (arrhythmias). This type is most often used to treat high blood pressure. The other type (the non-dihydropyridines, such as verapamil and diltiazem) is not recommended in patients who have chronic heart failure or certain types of abnormal heart rhythms (arrhythmias), since they may make these conditions worse. This type of CCB is most often used to treat chest pain.
Many calcium channel blockers come in a short-acting form and a long-acting (sustained release) form. Short-acting calcium channel blockers increase the risk of heart attack and stroke when used over an extended period and are therefore no longer used to treat high blood pressure.9
A large study of women aged 50 to 79 with high blood pressure but no history of heart disease had a higher risk of heart-related death when given combination therapy with a diuretic and CCB than with a diuretic and a beta blocker. Women treated with a CCB alone had a higher risk of heart-related death than women treated with a diuretic alone. Because of these findings, calcium channel blockers are not the drug of choice for lowering blood pressure in older women.10

What are the possible side effects and risks of calcium channel blockers?
The most common side effects of calcium channel blockers are a brief headache (that usually fades over time), edema (swelling) in the legs, constipation, fatigue, and stomach irritation. Some early studies found that calcium channel blockers could increase the risk of many types of cancer including breast and uterine cancer, but later studies showed that this is most likely not true.11, 12

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