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Mibefradil
Aka: Mibefradil, T-Type Calcium Channel Blocker
- See Also
- Calcium Channel Blocker
- Calcium Channel Blocker Overdose
- Dihydropyridine Calcium Channel Blocker (e.g. Amlodipine, Nifedipine)
- Diltiazem
- Verapamil
- Indications
- Chronic Stable Angina
- Hypertension
- Mechanism
- Blocks calcium influx at 2 types of calcium channels
- L-type (long-acting) channels
- Blocked by standard Calcium Channel Blockers
- T-type (transient) channels
- Blocked uniquely by Mibefradil
- Activated at lower voltages
- Present in:
- Vascular smooth muscle
- Myocardial conduction system
- Absent in
- Ventricular Myocardium
- Effect of Mibefradil
- Produces coronary and peripheral vasodilatation
- Does not result in reflex Tachycardia
- Efficacy
- Antihypertensive
- More effective then Diltiazem
- As effective as Amlodipine and Nifedipine
- Synergistic effect with ACE Inhibitors
- Anti-Anginal
- Delays onset of ischemia during Exercise
- Increases Exercise tolerance
- Contraindications
- Sick Sinus Syndrome
- AV Block without a Pacemaker
-
Drug Interactions
- Fatal Arrhythmia risk with
- Terfenadine
- Astemizole
- Cisapride
- Increases levels of
- Tricyclic Antidepressant
- Cyclosporine
- Adverse Effects
- See Calcium Channel Blocker
- Dizziness
- Fatigue
- Light headedness
- Peripheral Edema LESS common than others in class
- Dosing
- 50 mg PO qd (up to 100 mg PO qd)
- References
- (1997) Med Lett Drugs Ther 39:103-5 [PubMed]