Calcium Channel Blockers (CCBs) (cont.)
Annette (Gbemudu) Ogbru, PharmD, MBA
Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Jay W. Marks, MD
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
In this Article
- What are calcium channel blockers (CCBs) and how do they work?
- For what conditions are calcium channel blockers used?
- Are there any differences among calcium channel blockers?
- What are the side effects of calcium channel blockers?
- With which drugs do calcium channel blockers interact?
- What are examples of calcium channel blockers available?
What are the side effects of calcium channel blockers?
Common side effects of calcium channel blockers include:
- headache,
- constipation,
- rash,
- nausea,
- flushing,
- edema (fluid accumulation in tissues),
- drowsiness,
- low blood pressure, and
- dizziness.
Sexual dysfunction, overgrowth of gums, and liver dysfunction also have been associated with calcium channel blockers. Verapamil (Covera-HS, Verelan PM, Calan) and diltiazem (Cardizem LA, Tiazac) worsen heart failure because they reduce the ability of the heart to contract and pump blood.
With which drugs do calcium channel blockers interact?
Calcium channel blockers interact with several drugs.
- Verapamil (Covera-HS, Verelan PM, Calan) and diltiazem (Cardizem LA, Tiazac) reduce the elimination and increase the blood levels of
carbamazepine (Tegretol), simvastatin (Zocor), atorvastatin (Lipitor), and lovastatin (Mevacor). This can
lead to toxicity from these drugs.
- Several calcium channel blockers [for example,
diltiazem (Cardizem LA, Tiazac), felodipine (Plendil)]
increase the level of cyclosporine (Sandimmune,
Neoral,
Restasis) and similarly lead to toxicity of
cyclosporine.
- Grapefruit juice (1 glass, approximately 200ml) may elevate serum concentrations of verapamil (Covera-HS, Verelan PM, Calan), felodipine (Plendil), nifedipine (Adalat, Procardia), nicardipine (Cardene), nisoldipine (Sular), and possibly amlodipine (Norvasc).
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