What is a commonly used calcium (Ca) channel blocker?

From the Guidelines

Amlodipine is the most commonly used calcium channel blocker due to its favorable side effect profile and once-daily dosing. Amlodipine works by blocking L-type calcium channels in vascular smooth muscle cells, which prevents calcium influx, leading to vasodilation and reduced peripheral resistance 1. This mechanism makes it particularly effective for lowering blood pressure with minimal effects on heart rate or cardiac contractility.

Key Characteristics of Amlodipine

• Typically comes in doses of 2.5 mg, 5 mg, and 10 mg
• Most patients start at 5 mg once daily and potentially increase to 10 mg if needed for blood pressure control
• Common side effects include peripheral edema, headache, and flushing
• Can be used alone or in combination with other antihypertensive medications for enhanced blood pressure control Other commonly used calcium channel blockers include nifedipine, diltiazem, and verapamil, but amlodipine is often preferred due to its once-daily dosing and relatively favorable side effect profile 1.

Comparison with Other Calcium Channel Blockers

• Nifedipine and amlodipine have the most peripheral arterial dilatory effects but few or no AV or sinus node effects
• Verapamil and diltiazem have prominent AV and sinus node effects and some peripheral arterial dilatory effects as well
• All 4 of these agents, as well as other approved agents, have coronary dilatory properties that appear to be similar 1 The choice of calcium channel blocker should be based on the individual patient's needs and medical history, with consideration of potential side effects and interactions with other medications 1.

From the FDA Drug Label

Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow-channel blocker) Verapamil hydrochloride is a calcium ion influx inhibitor (slow-channel blocker or calcium ion antagonist) Nifedipine is a calcium ion influx inhibitor (slow-channel blocker or calcium ion antagonist)

Common calcium channel blockers include:

• Amlodipine 2
• Verapamil 3
• Nifedipine 4

From the Research

Common Calcium Channel Blockers

• Amlodipine is a commonly used calcium channel blocker, as stated in the study 5, which has been widely used for 2 decades and has good efficacy and safety.
• Nifedipine is another calcium channel blocker that is often used, as mentioned in the study 6, which compared the effectiveness of once-daily nifedipine with once-daily amlodipine in patients with mild-to-moderate essential hypertension.
• Verapamil and diltiazem are also calcium channel blockers, as discussed in the study 7, which noted that they are non-dihydropyridines and are among the most widely prescribed agents for the management of essential hypertension.

Characteristics of Calcium Channel Blockers

• Calcium channel blockers can be divided into two main categories: dihydropyridines (such as nifedipine and amlodipine) and non-dihydropyridines (such as verapamil and diltiazem) 7.
• Amlodipine has been shown to have markedly better anti-anginal efficacy than nifedipine, as demonstrated in the study 8.
• Nifedipine, verapamil, and diltiazem have different haemodynamic effects, as reviewed in the study 9, with nifedipine being the most potent arterial vasodilator.

Uses of Calcium Channel Blockers

• Calcium channel blockers are among the most widely prescribed agents for the management of essential hypertension, as stated in the study 7.
• They are also suitable for add-on therapy in combination with other agents, such as diuretics, angiotensin-converting enzyme inhibitors, and angiotensin-II receptor blockers 7.
• Amlodipine should be considered a first-line antihypertensive agent, as recommended in the study 5.