Calcium is an integral component in numerous physiological processes and functions. As such, drugs that interfere with the movement of calcium into or out of cells, or the activity of intracellular calcium are useful in treating a variety of disease states. This article will review the calcium channel blockers currently available, along with their approved indications, as well as select dihydropyridine investigational agents and nonapproved indications for their use.
Get full access to this article
View all access options for this article.
References
1.
Braunwald E. : Mechanism of action of calcium channel blocking agents. N Engl J Med307:1618-1627, 1982
2.
Bauman JL: The arrhythmias, in DiPiro JT, Talbert RL, Hayes PE, et al (eds): Pharmacotherapy: A Pathophysiologic Approach. New York, NY, Elsevier, 1989, pp 150-172
3.
Charlap S., Frishman WH: Calcium antagonists and heart failure. Med Clin North Am73:339-358, 1989
4.
Shah PM: Controversies in hypertrophic cardiomyopathy. Curr Probl Cardiol11:561-613, 1986
5.
Singh BN, Baky S., Nademanee K.: Second-generation calcium antagonists: Search for greater selectivity and versatility. Am J Cardiol55:214B-221B, 1985 (suppl)
6.
Tracy TS, Black CD: Calcium modulators: Future agents, future uses. Drug Intell Clin Pharm21:575-583, 1987
7.
Piepho RW, Culbertson VL, Rhodes RS: Drug interactions with the calcium-entry blockers. Circulation75:V181-V194, 1987 (suppl V)
8.
Pedersen KE, Dorph-Pedersen A., Hvidt S., et al: The long-term effect of verapamil on plasma digoxin concentration and renal digoxin clearance in healthy subjects. Eur J Clin Pharmacol22:123-127, 1982
9.
McFadden JP, Pontin JE, Powles AV, et al: Cyclosporin decreases nifedipine metabolism. Br Med J299:1224, 1989
10.
Kastrup EK, Olin BR, Connell SI, et al (eds): DrugFacts and Comparisons. Philadelphia, PA, Lippincott, 1990 , p 584
11.
1988Joint National Committee : The 1988 report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med148: 1023-1038,1988
12.
Frishman WH , Stroh JA, Greenberg S., et al: Calcium channel blockers in systemic hypertension. Med Clin North Am72:449-499, 1988
13.
Zanchetti A. : Role of calcium antagonists in systemic hypertension . Am J Cardiol59:130B-136B, 1987 (suppl)
14.
Krusell LR, Jespersen LT, Schmitz A., et al: Repetitive natriuresis and blood pressure. Long term calcium entry blockade with isradipine. Hypertension10:577-581, 1987
15.
Bauer J., Sobha S., Reams G.: Effects of calcium entry blockers on renin-angiotensin-aldosterone system, renal function and hemodynamics, salt and water excretion and body fluid composition . Am J Cardiol56:62H-67H, 1985 (suppl)
16.
Trost BN, Weidmann P.: Effects of calcium antagonists on glucose homeostasis and serum lipids in non-diabetic and diabetic subjects: A review. J Hypertens5:S81-S104, 1987 (suppl 4)
17.
Houston MC: The comparative effects of clonidine hydrochloride and nifedipine in the treatment of hypertensive crisis. Am Heart J115:152-159, 1988
18.
Rich S., Brundage BH: High-dose calcium channel-blocking therapy for primary pulmonary hypertension: Evidence for long-term reduction in pulmonary arterial pressure and regression of right ventricular hypertrophy. Circulation76:135-141, 1987
19.
Epstein SE, Quyyumi AA, Bonow RO: Myocardial ischemia—Silent or symptomatic. N Engl J Med318:1038-1043, 1988
20.
Cohn PF: Total ischemic burden. Am J Med86:6-8, 1989 (suppl 1A)
21.
Temkin LP: High-dose monotherapy and combination therapy with calcium channel blockers for angina. Am J Med86:23-26, 1989 (suppl 1A)
22.
Frishman WH , Skolnick AE, Lazar EJ, et al:β-Adrenergic blockade and calcium channel blockade in myocardial infarction. Med Clin North Am73:409-433, 1989
23.
Danish Multicenter Study Group on Verapamil in Myocardial Infarction: Verapamil in acute myocardial infarction. Am J Cardiol54:24E-28E, 1984
24.
Gibson RS, Boden WE, Theroux P., et al: Diltiazem and reinfarction in patients with non-Q-wave myocardial infarction. N Engl J Med315:423-426, 1986
25.
The Multicenter Diltiazem Postinfarction Trial Research Group: The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J 'Med319:385-392, 1988
26.
Colucci WS: Usefulness of calcium antagonists for congestive heart failure. Am J Cardiol59:52B-58B, 1987
27.
Charlap S., Frishman WH: Calcium antagonists and heart failure. Med Clin North Am73:339-358, 1989
28.
Maron BJ, Bonow RO, Cannon RO: Hypertrophic cardiomyopathy. Interrelations of clinical manifestations, pathophysiology and therapy (Parts I and II). N Engl J Med316:780-789, 844-852, 1987
29.
Chatterjee K.: Calcium antagonist agents in hypertrophic cardiomyopathy. Am J Cardiol59:146B-152B, 1987
30.
Petruk KC, West M., Mohr G.: Nimodipine treatment in poor-grade aneurysm patients. J Neurosurg68:505-517, 1988
31.
Gelmers HJ, Gortner K., de Weerdt CJ, et al: A controlled trial of nimodipine in acute ischemic stroke. N Engl J Med318:203-207, 1988
32.
Burges RA, Dodd MG, Gardiner DG: Pharmacologic profile of amlodipine. Am J Cardiol64:101-201, 1989
33.
Webster J., Robb OJ, Jeffers TA, et al: Once daily amlodipine in the treatment of mild to moderate hypertension . Br J Clin Pharm24:713-714,1987
Elmfeldt D. , Hedner T., Westerling S.: Felodipine in hypertension—A review . J Cardiovasc Pharmacol10:S154-S160, 1987 (suppl)
36.
Edgar B., Lundborg P., Regardh CG: Clinical pharmacokinetics of felodipine: A summary. Drugs34:16-27, 1987 (suppl 3)
37.
Agre K.: An overview of the safety and efficacy of nicardipine in clinical trials. Am J Cardiol59:31J-35J, 1987 (suppl)
38.
Armstrong C. , Garnham J., Blackwood R.: Comparison of the efficacy of nicardipine, a new calcium channel blocker, with nifedipine in the treatment of mild to moderate essential hypertension. Postgrad Med J63:463-466, 1987
39.
DeWood MA, Wolbach RA: Randomized double-blind comparison of side effects of nicardipine and nifedipine in angina pectoris. Am Heart J119:468-478, 1990 (suppl)
40.
Singh BN, Josephson MA: Clinical pharmacology, pharmacokinetics, and hemodynamic effects of nicardipine . Am Heart J119:427-434, 1990 (suppl)
41.
Santiago TM , Lopez LM: Nitrendipine: A new dihydropyridine calcium-channel antagonist for the treatment of hypertension. DICP Ann Pharmacother24:167-175, 1990
42.
Vanov SK, Pun Efc, Taylor RJ: The safety of nitrendipine in the treatment of essential hypertension—A review of 61 clinical studies. Angiology39:113-122, 1988
43.
Mroczek WJ, Burris JF, Allenby KS: Nitrendipine in severe hypertension. Hypertension1:1225-1228, 1988 (suppl I)
44.
Hof RP, Salzmann R., Siegl H.: Selective effects of PN200-110 (Isradipine) on the peripheral circulation and the heart. Am J Cardiol59:30B-36B, 1987 (suppl)
45.
Hamilton BP : Treatment of essential hypertension with PN 200-110 (Isradipine). Am J Cardiol59:141B-145B, 1987 (suppl)
46.
Pool PE, Seagren SC, Salel AF: Isradipine in the treatment of angina pectoris. Am J Med84:62-66, 1988 (suppl 3B)
47.
Greenberg BH , Siemienczuk D., Broudy D.: Isradipine improves cardiac function in congestive heart failure. Am J Med84:56-61, 1988 (suppl 3B)
48.
Tse Fls, Jaffe JM: Pharmacokinetics of PN 200-110 (Isradipine), a new calcium antagonist, after oral administration in man. Eur J Clin Pharmacol32:361-365, 1987
49.
Bittar N.: Usefulness of nifedipine for myocardial ischemia and the nifedipine gastrointestinal system. Am J Cardiol64:31F-34F, 1989 (suppl)
50.
Freedman DD , Waters DD: "Second generation" dihydropyridine calcium antagonists. Drugs34:578-598, 1987 50. Grossman E.,-Rosenthal T.: Nisoldipine: A replacement therapy for nifedipine in the treatment of severe hypertension. Clin Cardiol11:325-328, 1988
51.
Barjon JN, Rouleau JL, Bichet D., et al: Chronic renal and neurohumoral effects of the calcium entry blocker nisoldipine in patients with congestive heart failure. J Am Coll Cardiol9:622-630, 1987
52.
Freidel HA, Sorkin EM: Nisoldipine: A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of angina pectoris, hypertension, and related cardiovascular disorders. Drugs36:682-731, 1988
