Nondihydropyridine calcium channel blockers to reduce blood pressure

Nondihydropyridine calcium channel blockers have negative cardiac inotropic and chronotropic effects as well as modest vasodilatory effects. They may be useful in patients with both elevated blood pressure (BP) and stable angina. They are contraindicated in patients with left ventricular failure or significant systolic dysfunction (left ventricular ejection fraction 40% or less), as they may worsen myocardial function.

If a nondihydropyridine calcium channel blocker is considered appropriate to reduce BP, start with a low dose and increase slowly as required. Suitable dose ranges are: