Calcium Channel blockers: Spectrum of Side Effects and Drug Interactions

Hedner, Thomas

doi:10.1111/j.1600-0773.1986.tb02527.x

Cited by 34 publications

(7 citation statements)

References 72 publications

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“…We observed more frequent headaches with nifedipine than terbutaline, presumably secondary to nifedipine's vasodilatory effects [36][37][38], a result consistent with previous studies [10,39,40]. Overall, however, previous evidence summaries [2,21,22,31,41] have reported that nifedipine generates fewer total adverse events than terbutaline, a finding that our study confirmed.…”

Section: Discussioncontrasting

confidence: 51%

Nifedipine versus Terbutaline, Tocolytic Effectiveness and Maternal and Neonatal Adverse Effects: A Randomized, Controlled Pilot Trial

Padovani

Guyatt

Lopes

2014

Basic Clin Pharma Tox

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Although previous evidence suggests advantages of nifedipine over terbutaline as tocolytic agents, in some jurisdictions, terbutaline is approved for use and nifedipine is not. In women in preterm labour, we compared the impact of terbutaline versus nifedipine on inhibition of uterine contractions, preterm birth, neonatal sepsis, intracranial haemorrhage or necrotizing enterocolitis, death or admission to a neonatal intensive care unit and maternal adverse reactions. We randomized 32 women to nifedipine and 34 to terbutaline. We found no difference between groups in tocolysis or preterm birth. No serious maternal adverse effects or serious neonatal adverse outcome occurred in either group. Less serious maternal adverse effects less common with terbutaline included flushing (2.94% versus 43.7%) and headache (5.9% versus 31.2%). The administration of terbutaline increased tremor (76.4% versus 0%), nausea (58.8% versus 9.4%) and dizziness (29.4% versus 6.25%). The total number of side effects, and the proportion of women experiencing one or more side effects, proved greater with terbutaline. In this study, terbutaline and nifedipine performed similarly in their tocolytic effects. Each drug has specific side effects, although overall, nifedipine was associated with fewer adverse effects.Premature birth is common (over 5% and, in some countries, over 10%) [1,2] and is responsible for approximately 75% of all neonatal deaths and 50% of childhood neurological morbidities [3,4]. Preterm infants often require intensive care that is associated with emotional and economic costs to both the family and society [5].Approximately 75% of preterm birth is attributable to spontaneous preterm labour [1]. Delay in preterm labour therefore provides a potential opportunity for decreasing neonatal morbidity and mortality [6].The optimal medical management of threatened preterm labour is controversial [7]. Despite theoretical benefits of keeping the foetus in utero long enough to enable administration of a full course of corticosteroids to assist in foetal lung maturation, and to organize transfer to an appropriate neonatal care unit, no agent has been shown to improve neonatal outcome [2,7]. Thus, the choice of therapy has focused on delay in delivery and minimization of adverse effects.The drugs registered for tocolysis include the b adrenoceptor agonist ritodrine (United States and Europe), terbutaline (Brazil) and the oxytocin receptor antagonist atosiban (Europe) [8]. Calcium channel blockers (nifedipine) and cyclooxygenase inhibitors (indomethacin) are also used for inhibiting preterm labour although, in many countries, they are not currently registered for this indication [9].Betamimetics (isoxsuprine, ritodrine, terbutaline, fenoterol and salbutamol) delay labour [10][11][12], but their use has been limited by a high incidence of maternal adverse effects [10,13,14]. Many centres use nifedipine, which also has established effectiveness in delaying labour [15] and has advantages of oral administration and relatively low...

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Section: Discussioncontrasting

confidence: 51%

Nifedipine versus Terbutaline, Tocolytic Effectiveness and Maternal and Neonatal Adverse Effects: A Randomized, Controlled Pilot Trial

Padovani

Guyatt

Lopes

2014

Basic Clin Pharma Tox

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“… 10 AML is a third generation dihydropyridine L-type CCB used in the treatment of angina pectoris, arterial hypertension, and cardiac arrhythmias. 11 …”

Section: Introductionmentioning

confidence: 99%

The effects of amlodipine and platelet rich plasma on bone healing in rats

Atalay¹,

Bozkurt²,

Gönül³

et al. 2015

DDDT

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AimThe aim of this study was to evaluate the effects of calcium channel blocker (CCB) amlodipine (AML), platelet rich plasma (PRP), and a mixture of both materials on bone healing.Materials and methodsFifty-six male Wistar rats were randomly divided into four groups: group A, tibia defect model with no treatment; group B, tibia defect model treated with AML, 0.04 mg daily by oral gavage; group C, tibia defect model treated with local PRP; group D, tibia defect model treated with local PRP and AML, 0.04 mg daily by oral gavage.ResultsAt day 21, bone healing was significantly better in groups C and D compared to group A (P<0.05), but comparisons showed no statistically significant difference in group B (P>0.05). At day 30, groups B and C showed no statistically significant difference (P>0.05) compared to group A, but bone healing in group D was significantly better than in group A (P<0.05). Statistically, AML did not affect alkaline phosphatase (ALP) activity at 21 and 30 days (P>0.05), but PRP and AML + PRP increased ALP activity statistically (P<0.05).ConclusionIt can be concluded that AML had neither a positive nor a negative effect on bone healing, but when used in combination with PRP, it may be beneficial.

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“…This drug has shown a wide range of therapeutic effect, but often it is abandoned due to side effects such as pronounced hypotension, diarrhea, hepatotoxicity, mental confusion, and even death (Hedner 1986; Kloner 1995). It has also been shown to cause gastritis in the GI tract (Lavy 1999).…”

Section: Introductionmentioning

confidence: 99%

Nifedipine nanoparticle agglomeration as a dry powder aerosol formulation strategy

Plumley

Gorman

El-Gendy

et al. 2009

International Journal of Pharmaceutics

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Efficient administration of drugs represents a leading challenge in pulmonary medicine. Dry powder aerosols are of great interest compared to traditional aerosolized liquid formulations in that they may offer improved stability, ease of administration, and simple device design. Particles 1-5 µm in size typically facilitate lung deposition. Nanoparticles may be exhaled as a result of their small size; however, they are desired to enhance the dissolution rate of poorly soluble drugs. Nanoparticles of the hypertension drug nifedipine were co-precipitated with stearic acid to form a colloid exhibiting negative surface charge. Nifedipine nanoparticle colloids were destabilized by using sodium chloride to disrupt the electrostatic repulsion between particles as a means to achieve the agglomerated nanoparticles of a controlled size. The aerodynamic performance of agglomerated nanoparticles was determined by cascade impaction. The powders were found to be well suited for pulmonary delivery. In addition, nanoparticle agglomerates revealed enhanced dissolution of the drug species suggesting the value of this formulation approach for poorly water soluble pulmonary medicines. Ultimately, nifedipine powders are envisioned as an approach to treat pulmonary hypertension.

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Calcium Channel blockers: Spectrum of Side Effects and Drug Interactions

Cited by 34 publications

References 72 publications

Nifedipine versus Terbutaline, Tocolytic Effectiveness and Maternal and Neonatal Adverse Effects: A Randomized, Controlled Pilot Trial

Nifedipine versus Terbutaline, Tocolytic Effectiveness and Maternal and Neonatal Adverse Effects: A Randomized, Controlled Pilot Trial

The effects of amlodipine and platelet rich plasma on bone healing in rats

Nifedipine nanoparticle agglomeration as a dry powder aerosol formulation strategy

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