Dihydropyridine calcium channel blockers to reduce blood pressure

For general information about drugs used for blood pressure (BP) reduction, and starting and adjusting drug therapy, see Approach to drug therapy for blood pressure reduction.

Dihydropyridine calcium channel blockers have a predominantly vasodilator action. They are particularly useful in patients with stable angina in addition to elevated BP.

While dihydropyridine calcium channel blockers are usually well tolerated, their vasodilatory action can cause peripheral oedema. The peripheral oedema is caused by fluid redistribution rather than retention and should not be treated with diuretics. If the peripheral oedema does not subside, it may be necessary to reduce the dose or stop therapy.

Start with a low to moderate dose and increase slowly as required. Suitable dose ranges for a patient with uncomplicated elevated BP are:

A lower starting dose than the doses listed above is appropriate in some patients, such as older patients.