Calcium channel blockers
How dihydropyridine and non-dihydropyridine calcium channel blockers act on L-type channels in vascular smooth muscle, myocardium and nodal tissue, and how that tissue selectivity explains their uses, oedema, interactions and overdose.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Calcium channel blockers (CCBs) block the L-type (Cav1.2) channel, which carries calcium into vascular smooth muscle, cardiac myocytes and SA and AV nodal cells.
- Dihydropyridines (amlodipine, felodipine, lercanidipine, nifedipine, nimodipine) are vascular-selective: vasodilation with little direct cardiac effect.
- Verapamil (phenylalkylamine) is cardiac-selective, and diltiazem (benzothiazepine) is in between. Both slow the SA and AV nodes and depress contractility.
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Sources
- Therapeutic Guidelines: CardiovascularAU/NZTherapeutic Guidelines Limited, 2026
- Australian Medicines HandbookAU/NZAustralian Medicines Handbook Pty Ltd, 2026
- McEvoy JW, McCarthy CP, Bruno RM et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J 2024;45:3912-4018European Heart Journal (ESC), 2024
- Australian and New Zealand Living Clinical Guidelines for Stroke Management (subarachnoid haemorrhage)AU/NZStroke Foundation, Living guideline
- Wiggins BS, Saseen JJ, Page RL et al. Recommendations for management of clinically significant drug-drug interactions with statins and select agents used in patients with cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2016;134:e468-e495Circulation (American Heart Association), 2016
- Dahlöf B, Sever PS, Poulter NR et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril versus atenolol adding bendroflumethiazide (ASCOT-BPLA). Lancet 2005;366:895-906The Lancet, 2005
- Last updated
- 14 November 2026
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