Pharm
Dihydropyridine Calcium Channel Blocker
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Dihydropyridine Calcium Channel Blocker
, Amlodipine, Norvasc, Dihydropyridine
See Also
Calcium Channel Blocker
Calcium Channel Blocker Overdose
Nifedipine
Diltiazem
Verapamil
Mibefradil
Nicardipine
Clevidipine
Nimodipine
(
Nymalize
)
Mechanism
Dihydropyridine Calcium Channel Blockers
Dihydropyridines are primarily active at vascular
Smooth Muscle
Contrast with
Non-Dihydropyridine
s which are also active at cardiac
Smooth Muscle
Nifedipine
(
Procardia
) is prototype for class
Contraindications
Avoid in
Diabetes Mellitus
(may increase
Proteinuria
)
Drug Interactions
Clarithromycin
Increases
Calcium Channel Blocker
levels via
CYP3A4
inhibition especially with Dihydropyridines and over age 65 years
Provokes
Hypotension
and
Bradycardia
Risk of
Acute Kidney Injury
(often requiring hospitalization)
References
Gandhi (2013) JAMA 310(23):2544-53 [PubMed]
Preparations
Oral
Nifedipine
(
Procardia
)
Amlodipine (Norvasc)
Dosing
2.5-5mg PO qd (MAX 10mg qd)
Advantages
Does not exacerbate
Left Ventricular Dysfunction
Felodipine
Nimodipine
(
Nymalize
)
Preparations
Parenteral (
Hypertensive Emergency
)
Background
Counter
Cerebral Vessel
spasm (e.g. early
Subarachnoid Hemorrhage
, CVA)
Clevidipine
(
Cleviprex
)
Nicardipine
Adverse Effects
See
Calcium Channel Blocker
Peripheral Edema
(Norvasc)
Occurs more commonly in women
Occurs more commonly on Norvasc doses >5 mg
Adding
ACE Inhibitor
to regimen decreases edema
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