From the Guidelines
Calcium Channel Blocker with the Fastest Onset of Action
The calcium channel blocker with the fastest onset of action is Nicardipine, with an onset of action of 1-5 min 1.
Comparison of Onset of Action
Other calcium channel blockers have the following onset of action:
- Nifedipine short-acting: 5-10 min 1
- The evidence does not provide a direct comparison of the onset of action of all calcium channel blockers, but Nicardipine has the fastest onset of action among the ones listed in the provided evidence.
Clinical Considerations
When choosing a calcium channel blocker, it is essential to consider the clinical context and the specific properties of each medication, including their onset of action, duration of action, and potential side effects 1.
Key Points
- Nicardipine has an onset of action of 1-5 min and is administered via iv (infusion) 1
- Nifedipine short-acting has an onset of action of 5-10 min and is administered orally 1
- The choice of calcium channel blocker should be based on individual patient needs and clinical circumstances 1
From the Research
Calcium Channel Blockers with Fast Onset of Action
- Clevidipine is a third-generation IV dihydropyridine calcium channel blocker with an ultra-fast onset and offset of blood pressure lowering effect 2
- Intravenous nicardipine has a rapid onset of action and a short half-life, making it suitable for the management of hypertensive crisis in children 3
- Nifedipine, by oral or buccal administration, has a rapid onset of action and reasonable duration of effect, making it useful in a variety of settings 4
- Verapamil, by intravenous administration, has a rapid onset of action, a reasonable duration of effect, and a good side-effect profile 4
Comparison of Onset of Action
- The onset of action of verapamil, nifedipine, and diltiazem is relatively fast (0.5-2 hours) 5
- Clevidipine has an ultra-fast onset of action, but the exact time frame is not specified in the study 2
- Intravenous nicardipine has a rapid onset of action, but the exact time frame is not specified in the study 3
Clinical Use of Calcium Channel Blockers
- Calcium channel blockers are used to treat hypertension, including acute hypertensive emergencies 2, 3, 4
- They are also used to control blood pressure in patients with preoperative hypertension and postoperative hypertension 2
- The choice of calcium channel blocker depends on the clinical setting, efficacy, rapidity of onset of action, duration of action, and ease of administration 4