Table TABLE.
Calcium Channel Blockers
| Name | Half‐life, h | Dose, mg/times per day | Affect LV function | Market, % | Approved by FDA for | Major Outcome‐Based Hypertension Trials |
|---|---|---|---|---|---|---|
| Verapamil | 6–8 | 80–120/2 | – | ∼8% | Hypertension, angina, atrial dysrhythmias | VHAS, CONVINCE, 10 INVEST 11 |
| (Calan, Isoptin) | 12–24 | 80–480/1 | ||||
| (Calan SR, Isoptin SR, Verelan) | 24 | 180–300/1 | ||||
| (Covera‐HS, Verelan‐PM) | ||||||
| Diltiazem | 6–8 | 30–90/3 | – | ∼11% | Hypertension, angina, atrial dysrhythmias | NORDIL 12 |
| (Cardizem) | 8–12 | 120–180/2 | ||||
| (Cardizem SR, Tiazac, others) | 18–24 | 120–480/1 | ||||
| 24 | 120–540/1 | |||||
| (Cardizem CD, Cartia XT, others) | ||||||
| (Cardizem LA) | ||||||
| Nifedipine | 0.2–1 | 10–20/4–6 | – | ∼5% | Hypertension, angina | INSIGHT, 13 STONE |
| (Procardia, Adalat) | 24 (?) | 30–120/1 | ||||
| (Procardia XL, Adalat CC) | ||||||
| Nicardipine | 6–8 | 20–30/3 | – | Small | Hypertension | NICS‐EH |
| (Cardene) | 8–12 | 30–60/2 | ||||
| (Cardene SR) | ||||||
| Isradipine | 8–12 | 2.5–5/2 | − or ± | Small | Hypertension | MIDAS |
| (DynaCirc) | 12–18 | 5–10/1 | Small | |||
| (DynaCirc CR) | ||||||
| Felodipine | 11–16 | 2.5–10/1 | ± or 0 | ∼3% | Hypertension | HOT, 14 FEVER 15 (second‐line) |
| (Plendil) | ||||||
| Amlodipine | 44+ | 2.5–10/1 | ± or 0 | ∼71% | Hypertension, angina | AASK, 8 IDNT, 9 ALLHAT, 5 VALUE, ASCOT, 16 CASE‐J, ACCOMPLISH 17 (combination) |
| (Norvasc) | ||||||
| Nisoldipine | 7–12 | 10–40/1 | − or ± | ∼2% | Hypertension | ABCD |
| (Sular) | ||||||
| Clevidipine | 0.25 | 1–2 mg/h, intravenously only | ± | Tiny | Hypertensive emergencies | Reflex tachycardia, hypotension |
| (Cleviprex) | ||||||
| Nimodipine | 1–2 | 30/4–6 | – | Tiny | Subarachnoid hemorrhage | Metabolized by CYP3A4; |
| (generic only in United States after October 2009) | not approved for hypertension! |
Abbreviations: AASK, African American Study of Kidney Diseases and Hypertension; ABCD, Appropriate Blood Pressure Control in Diabetes; ACCOMPLISH, Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension; ALLHAT, Antihypertensive and Lipid Lowering to Prevent Heart Attack Trial; ASCOT, Anglo‐Scandinavian Cardiac Outcomes Trial; CASE‐J, candesartan antihypertensive survival evaluation in Japan; CONVINCE, Controlled Onset Verapamil Investigation of Cardiovascular Endpoints; CYP3A4, 3A4 Isoform Of Hepatic Cytochrome P450 Enzyme System; FEVER, Felodipine Event Reduction; HOT, Hypertension Optimal Treatment Study; IDNT, Irbesartan Diabetic Nephropathy Trial; INSIGHT, International Nifedipine (Gastrointestinal Therapeutic System) Study: Intervention as a Goal in Hypertension Treatment; INVEST, International Verapamil‐Sustained Release/Trandolapril Trial; MIDAS, Multicenter Isradipine Diuretic Atherosclerosis Study; NICS‐EH, National Intervention Cooperative Study In Elderly Hypertensives; NORDIL, Nordic Diltiazem; STONE, Shanghai Trial of Nifedipine in the Elderly; VALUE, Valsartan Antihypertensive Long‐Term Use Evaluation; VHAS, Verapamil Hypertension Atherosclerosis Study.