Calcium channel blocking agents (CCBs) inhibit the movement of calcium ions across the cell membrane by blocking the L-type (slow) calcium ion channel. CCBs have Food and Drug Administration (FDA) indications for treating hypertension, angina, and supraventricular arrhythmias, depending on the specific drug. Calcium channel blocking agents are generally classified into three groups according to their chemical structure: benzothiazepines (diltiazem); phenylalkylamines (verapamil); and the dihydropyridines (amlodipine, bepridil, felodipine, isradipine, nicardipine, nifedipine, and nisoldipine). Because these groups are included in the same drug class but have some differences in both mechanisms of action and side effects, there is concern that the effectiveness and safety may vary by dihydropyridine and non-dihydropyridine groupings. The purpose of this review is to compare the efficacy, effectiveness, and adverse effects of calcium channel blockers.

Contents

• Introduction
  • Dihydropyridines vs non-dihydropyridines
  • Scope and Key Questions
• Methods
  • Literature Search
  • Study Selection
  • Data Abstraction
  • Validity Assessment
  • Data Synthesis
• Results
  • Overview
  • Key Question 1: Do CCBs differ in effectiveness in the treatment of adult patients with essential hypertension (blood pressure ≥ 140/90 mm Hg), angina, supraventricular arrhythmias, or systolic dysfunction (LVEF <45%)?
  • Key Question 2: Do CCBs differ in safety or adverse effects in the treatment of adult patients with essential hypertension (blood pressure ≥ 140/90 mm Hg), angina, supraventricular arrhythmias, or systolic dysfunction (LVEF <45%)?
  • Key Question 3: Based on demographics (age, racial groups, gender), other medications, or comorbidities, are there subgroups of patients for which one CCB is more effective or is associated with fewer adverse effects?
• Summary
• References
• Appendixes
  • Appendix A. Calcium Channel Blockers Search Strategies Update #2
  • Appendix B. Quality Assessment Methods for Drug Class Reviews for the Drug Effectiveness Review Project
  • Appendix C. Reports of Trials Excluded
  • Appendix D. Articles Available as Abstracts Only
  • Appendix E. Quality of Life Studies Under Six Months Duration
  • Appendix F. List of Abbreviations for Tables
• Evidence Tables

The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.