Which medications in the drug class Calcium Channel Blockers are used in the treatment of Hypertension?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Calcium Channel Blockers

Calcium channel blockers (CCBs) can be divided into dihydropyridines and nondihydropyridines. Dihydropyridines bind to L-type calcium channels in the vascular smooth muscle, which results in vasodilatation and a decrease in blood pressure. They are effective as monotherapy in black patients and elderly patients. Some examples of dihydropyridines include amlodipine, nifedipine, clevidipine, and felodipine. Non-dihydropyridines such as verapamil and diltiazem bind to L-type calcium channels in the sinoatrial and atrioventricular node, as well as exerting effects in the myocardium and vasculature. These agents may constitute a more effective class of medication for black patients. [146]

Nifedipine (Adalat CC, Afeditab CR, Nifediac CC, Nifedical XL, Procardia XL)

Nifedipine extended-release is indicated for the treatment of hypertension alone or in combination with other antihypertensive agents. The usual dose for nifedipine is 30-60 mg once daily (maximum 90 mg/day); when used for hypertension, nifedipine can be administered to a maximum of 120 mg/day.

Clevidipine (Cleviprex)

Clevidipine butyrate is a dihydropyridine L-type CCB that is rapidly metabolized in blood and tissues and does not accumulate in the body. L-type calcium channels mediate the influx of calcium during depolarization in arterial smooth muscle. It is indicated for the reduction of BP when oral therapy is not feasible or is not desirable.

Amlodipine (Norvasc)

Amlodipine is a dihydropyridine CCB that has antianginal and antihypertensive effects. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.

Felodipine (Plendil)

Felodipine is a dihydropyridine CCB that inhibits the influx of extracellular calcium across the myocardial and vascular smooth muscle cell membranes. These effects elicit an increased oxygen delivery to the myocardial tissue, a decreased total peripheral resistance, a decreased systemic blood pressure, and a decreased afterload.

Diltiazem (Cardizem CD, Cardizem LA, Cartia XT, Dilacor XR, Dilt-CD, Dilt-XR, Matzim LA, Taztia XT, Tiazac)

Diltiazem is a nondihydropyridine CCB that produces its antihypertensive effect primarily by relaxation of vascular smooth muscle and the resultant decrease in peripheral vascular resistance. The magnitude of blood pressure reduction is related to the degree of hypertension.

Verapamil (Calan, Calan SR, Covera-HS, Isoptin SR, Verelan, Verelan PM)

Verapamil is a nondihydropyridine that produces its antihypertensive effect by a combination of vascular and cardiac effects. It acts as a vasodilator with selectivity for the arterial portion of the peripheral vasculature. As a result, the systemic vascular resistance is reduced, usually without orthostatic hypotension or reflex tachycardia.


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