Calcium Channel Blockers

The first attempt at creating a calcium channel blocker dates back to as early as 1025, and was an herbal supplement. Fast forward to western medicine times and the first FDA approved calcium channel blocker was Verapamil. Verapamil received it’s FDA approval in 1981. And since then calcium channel blockers have been prescribed to treat a number of cardiovascular conditions. They are prescribed mainly for high blood pressure, but can also be prescribed for Angina, coronary artery disease, and irregular heartbeats. Let’s dive right in to how it works, how well it treats high blood pressure, and what the side affects are.

Calcium channel blockers stop calcium from entering your heart and arteries. This in turn widens the arteries and blood vessels. Therefore causing less of a strain on the heart, and allowing the heart to beat more freely. This lowers blood pressure because of the reduced strain on the heart. Calcium channel blockers have been known to reduce blood pressure more effectively than most other drugs out there, so that is important factor to take into consideration. With some studies being done showing the effects of these drugs on people who have used them for over 30 years. However many doctors do not prescribe them as a first line treatment to  hypertension. Especially doctors who were trained recently, or keep up with new medical research journals. The side effects are the main reason they are not prescribed as much as other drugs such as ACE inhibitors.

Preventing strokes is key to patients with severe hypertension or coronary artery disease. And calcium channel blockers seem to be one of the best at this. This seems to be the case because of how much they increase the size of the arteries and blood vessels. Beta blockers and ACE inhibitors (two of the most prescribed medications for hypertension) both do not dilate blood vessels as effectively as calcium channel blockers. This effect is most helpful in people with coronary artery disease, who can have a larger pathway for blood to flow since the passageways in the arteries are narrowed from a plaque build up. Plaque is a build up of cholesterol and fat along the artery wall.

The two different types of calcium channel blockers inculde Dihydropyridines and Non-Dihydropyridines. Dihydropyridines are very strong vasodilators which have little to no effect on the heart. They are preferred for treatment of hypertension because of there stronger dilation abilities. Non-Dihydropyridines on the other hand have a less potent effect on blood vessel dilation. They also have an effect on the way the heart beats. When taking a non-dihydropyridines calcium channel blocker the heart will beat in and out with less intensity. Similar to the effects of a beta blocker. It is important to note that Dihydropyridines end with “pine”. Ex- Amlodipine, Nifedipine. While non-dihydropyridines end with “mil” and ”em”. Ex- Diltiazem, and verapamil.

Side effects may include rashes, headache, dizziness, hypotension, fast heartbeat, extreme fatigue, drowsiness, weakness, flushing, stomach issues, stomach pain, constipation, bloating, weight gain, nausea, heartburn, trembling, shaking of the hands, tingling or tightness in the chest, tingling in other parts of the body, feeling of warmth, cough, muscle cramps, muscle pain, pain in the lower back, pain in the shoulder area, pain in the eye, difficulty breathing, wheezing, chills, cramps, increased sweating, dilated neck veins, trouble with exertion, unusual bleeding or bruising, anxiety, nervousness, panic attacks, itching, paleness, belching, stuffy nose, hair loss, sensitivity to sunlight, loss of strength, loss of pleasure or excitement, personality disorders, feeling cold all the time, fever, and swelling of the lower extremities.    

The side effects of calcium channel blockers can differ from individual to individual. The most prevalent one is fatigue, patients who experience this will often find higher dosages make this worse. Both extended release and regular capsules cause this. Some patients will take calcium channel blockers for a few months or even over a year and not experience this, and it gradually starts after taking the drug for an extended period of time. While other patients might notice the fatigue right away.

Dizziness is another common side effect. At higher dosages the dizziness can be bad enough to impair driving abilities. This can occur because of the increased size of the blood vessels in the brain, or from your blood pressure being too low. Some patients have also had a feeling of pressure on the head.

Flushing can occur the first few weeks of taking this medication. Some patients see the flushing disappear after a few weeks of using the drug, and some do not. Some patients will experience flushing at only higher dosages. This is thought to occur because of the size of the blood vessels in the face being widened.

The next side effect were going to talk about here tends to be the most annoying for a lot of people, and that is the fast heart rate. Because calcium channel blockers increase the size of the blood vessels and arteries, the heart has an easier time beating. This in turn can cause it to beat faster, many people report having a resting heart rate 10 to 15 beats per minute higher than when they were off the drug.

This common side effect that tends to scare some people, because it mimics the signs of the heart not working properly. But in fact it is just a side effect of using a calcium channel blocker. And this is the swelling of the legs and feet. You can experience swelling in any of the lower extremities, but the legs and feet are most common. A few patients have even reported swelling in their hands from taking calcium channel blockers. The medical term for this is called edema. The real reason why this happens is because this drug can cause issues with the salt passage ways in your body. A lot of medical professionals will treat this with diuretics, obviously those come with their own set of side effects and possible dangers.

There are some rare side effects of calcium channel blockers that the larger majority of people do not experience. But they have been reported before, and these include gum issues (gums growing over the teeth), ringing in the ears, an intestinal blockage, uneven heartbeats, and fainting.

Because of the fact that calcium channel blockers cause tachycardia, there could possibly be an increased risk of heart attack for some patients. Though more data is needed on this, one study showed that calcium channel blockers may increase a patients chance of getting a heart attack by up to %60. The drug maker Pfizer who currently makes Nifedipine, stated that the extended release tablets pose a lower risk of this in comparison with the fast acting calcium channel blockers.

There are mental side effects that may occur from calcium channel blockers. Just like the effects of beta blockers, these drugs can make you feel a general disinterest towards things you once found interesting and exciting. They can make you have a dull outlook on life. This happens because of the sedative effect of the drug and the chemical imbalances they cause.

Calcium channel blockers are used in some cases to control bipolar disorder. This should give you an idea of how potent of an effect these drugs can have on your brain. Some patients taking calcium channel blockers may see a change in their personality. They may get frustrated easier, have less patience, or not be able to handle bad news as well. It has also been reported that patients can have events of lashing out. Make sure to look for signs of this if you are thinking about taking this drug or are already on it.  

Brain fog can be severe on high doses of calcium channel blockers. People often report extreme tiredness along with a hazy feeling. This side effect is purely annoying and inconvenient and does not cause any actual harm to the body, although it can hinder a patients ability to go about the chores of their daily life.

When stopping calcium channel blockers you can experience a rebound effect in blood pressure. The dosage should be tapered down slowly before discontinuation. Abrupt discontinuation can cause angina or worsening angina if you had it already, it can cause blood pressure to spike to unsafe levels, and it might also cause an irregular heart beat. In people with coronary artery disease, abrupt cessation may also increase the risk of stroke. It can also cause panic attacks and anxiety, because of the drugs sedative effects. You may have these symptoms mildly even when tapering off slowly, but they should be less severe. Always check with your doctor before discontinuing any medication.

Always avoid grapefruit juice when using calcium channel blockers. Grapefruit juice can increase the amount of the drug in the blood stream which can be very dangerous.