Calcium blockers

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Calcium-channel blockers (CCBs for short) are medicines that are often used to treat high blood pressure. There are a few different types of CCB and each works in a slightly different way. Most of these medicines will have names that end in “ipine”.

All about calcium-channel blockers (CCBs)

How do calcium-channel blockers (CCBs) work?

Your body will sometimes use calcium to narrow your blood vessels and this can raise your blood pressure. Calcium-channel blockers (CCBs) lower your blood pressure by blocking the effects of calcium on your blood ­vessels. This helps your blood vessel walls relax and widen, making it easier for blood to flow through.

Video - how calcium-channel blockers work

Who might be given calcium-channel blockers (CCBs)?

Most people who have high blood pressure will need to take one or more medicines to control it. Calcium-channel blockers (CCBs) are a popular first-choice medicine for high blood pressure.

They are particularly recommended for people who are over 55 or who are of African Caribbean origin. However, even if neither of these apply to you, you may be given a CCB as a first choice. If you need to take more than one medicine to ­control your blood pressure enough, you may be given a CCB as a second or third medicine.

Calcium-channel blockers can be an effective treatment for people who have more severely raised blood pressure. If you have high blood pressure and are pregnant or breastfeeding you could also be given a CCB.

One calcium-channel blocker called verapamil has the added effect of slowing your heart rate. You may be given this medicine if you have angina or an irregular heart beat in addition to high blood pressure.

Who would not be given calcium-channel blockers (CCBs)?

Rarely, calcium-channel blockers (CCBs) can interfere with other health ­problems you may have, or with medicines you are taking. Your doctor should always consider your overall health and treatment, not just blood pressure treatment, before giving you any new medicine.

Some people who are given a CCB will need to be monitored closely. These include pregnant and breastfeeding women, people with kidney or liver problems and those with heart failure, heart ­damage or abnormal heart rhythms.

Calcium-channel blockers (CCBs) used in the UK

Medicine name Brand names 
Amlodipine Amlostine, Exforge, Istin 
Diltiazem Adizen-SR, Adizem-XL, ­Diltiazem, Dilzem SR, Dilzem XL, Slozem, Tildiem, Tildiem LA, Tildiem Retard, Viazem XL 
Felodopine Felotens XL, Plendil, Triapin, ­Triapin Mite, Vascalpha
Isradipine Prescal 
Lacidipine Motens 
Lercanidipine Zanidip 
Nicardipine Cardene 
Nifedipine Nifedipine Adalat, Adalat LA, Adalat Retard, Beta-Adalat, Coracten SR, Coracten XL, Nifedipress, Tenif, Tensipine 
Nisoldipine Syscor 
Verapamil Securon SR, Tarka, Univer, ­Verapamil, Verapress 

Do calcium-channel blockers (CCBs) have side-effects?

Most people will have no side-effects from their blood pressure medicines. They usually only ­happen when you start to take a new medicine, or a higher dose of your medicine. If you do ­experience a side-effect it may lessen over time as your body gets used to the medicine. If not, your doctor may change your dosage or your medicine if they feel it is appropriate.

Possible side-effects of calcium-channel blockers include:

  • swollen ankles 
  • ankle or foot pain
  • constipation
  • skin rashes
  • a flushed face
  • headaches
  • dizziness or tiredness
  • swollen or bleeding gums (rarely)
  • some men may feel the need to urinate more during the night.

Other things to be aware of when taking calcium-channel blockers (CCBs)

If you are taking a calcium-channel blocker you should not drink grapefruit juice. This is because it increases the amount of medicine that enters your blood stream. As a result, your blood pressure can drop very suddenly, which can be dangerous. Apart from amlodipine and diltiazem, almost all CCBs will be affected by grapefruit juice. As far as we are aware, the juice from oranges and other fruits is considered safe.

Check with your doctor or pharmacist before ­taking any other medicines in combination with your calcium-channel blocker – this includes over-the-counter ­treatments.

As with other blood pressure lowering medicines, once you start taking a CCB, be prepared to stay on it for the long term. Some people stop taking their blood pressure medicines when they think their blood pressure is under control, but doing this can put your health at risk.

If you have angina and stop taking your CCB ­suddenly you could ­experience chest pain.

If you have any concerns about your medicines, speak to your doctor or pharmacist.

Published May 2009

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