Calcium Channel Blockers for Coronary Artery Disease
Examples
|
| amlodipine besylate | Norvasc |
| diltiazem hydrochloride | Cardizem, Tiazac |
| felodipine | Plendil |
| nifedipine | Adalat |
| verapamil hydrochloride | Isoptin SR |
How It Works
Calcium channel blockers help treat
coronary artery disease by:
- Increasing blood flow to the heart muscle by
expanding (dilating) the coronary arteries.
- Possibly help to
prevent a spasm of the coronary arteries.
- Lowering blood pressure
and the workload on the heart, which allows the heart muscle to function with
less oxygen and blood flow.
- Sometimes slowing a rapid heart rate
and controlling irregular heart rhythms.
Why It Is Used
Calcium channel blockers are commonly
used in people with coronary artery disease who have one or more of the
following conditions:1
- Stable angina
- Episodes of
spasm affecting the coronary arteries
- Inability to take
beta-blockers, or beta-blockers are ineffective in controlling a rapid heart
rhythm
How Well It Works
Calcium channel blockers can help
reduce the severity and frequency of chest pain when beta-blockers cannot be
used.1 Unlike beta-blockers, however, these
medications do not reduce your risk of a future heart attack.
Side Effects
Side effects vary depending on the drug,
but may include:
- Slowed heart rate or irregular heart
rhythm.
- Flushing, a pounding sensation in the head, dizziness,
headache.
- Leg swelling.
- Decreased blood
pressure.
- Tingling sensations in the arms or
legs.
- Weakness.
- Constipation.
Nifedipine, verapamil, and diltiazem may cause skin rash or
breast enlargement.
See Drug Reference for a full list of side
effects. (Drug Reference is not available in all systems.)
What To Think About
Calcium channel blockers are most
effective when they are combined with nitrates and beta-blockers, but their
dosage must be monitored carefully to prevent side effects. Nifedipine,
amlodipine, and felodipine are used most commonly in people already taking
beta-blockers. You can also take amlodipine in a combination dose with the
statin atorvastatin, which treats high cholesterol.
Therefore, this combination helps reduce chest pain and treats high cholesterol
at the same time.
In general, the long-acting forms (taken once a
day) of calcium channel blockers are preferred over the short-acting forms
(taken 2 to 4 times per day).
Verapamil, diltiazem, and nifedipine
may worsen heart failure. Amlodipine and felodipine do not appear to worsen
heart failure.
Verapamil or diltiazem sometimes are used when a
person cannot take beta-blockers.
Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.
References
Citations
- Snow V, et al. (2004). Primary care management of
chronic stable angina and asymptomatic suspected or known coronary artery
disease: A clinical practice guideline from the American College of Physicians.
Annals of Internal Medicine, 141(7): 562–567. Also
available online: http://www.annals.org/cgi/reprint/141/7/562.pdf.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Brian D. O'Brien, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | John A. McPherson, MD, FACC, FSCAI - Cardiology |
|---|
| Last Revised | August 12, 2010 |
|---|
Last Revised:
August 12, 2010
Snow V, et al. (2004). Primary care management of
chronic stable angina and asymptomatic suspected or known coronary artery
disease: A clinical practice guideline from the American College of Physicians.
Annals of Internal Medicine, 141(7): 562–567. Also
available online: http://www.annals.org/cgi/reprint/141/7/562.pdf.
