What causes calcium channel blocker (CCB) toxicity?

Updated: Jan 04, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Answer

The toxic potential of calcium channel blockers (CCBs) varies with the formulation (eg, immediate-release or sustained-release) and the pharmacologic subclass. The CCBs have a certain degree of tissue specificity, but the drugs do have common properties. CCBs are all well absorbed in the gastrointestinal (GI) system, although diltiazem has extensive first-pass metabolism. The CCBs are substantially bound by plasma proteins and are predominantly metabolized by the liver. Therefore, impaired renal function should not alter CCB metabolism.


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