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Back one screen: left arrow Back to main menu: ESC CALCIUM CHANNEL BLOCKERS : PROPERTIES Three calcium channel blockers are presently available in the USA: diltiazem, nifedipine, and verapamil. Their major in- dication is in the treatment of angina. Pharmacokinetics (dosage forms ) * Absorption: All 3 agents are well absorbed from the gut. Nifedipine is also rapidly absorbed from the buccal mucosa. * Elimination: Nifedipine and verapamil are excreted primarily by the kidneys into the urine; diltiazem and its metabolites appear in the feces. Other Indications of the Calcium Channel Blockers * Arrhythmias: Verapamil is labeled for use in supraventricular arrhythmias (see Chapter 3). * Hypertension: Verapamil has recently been approved for use in hypertension. Nifedipine and diltiazem are also useful (but at present unlabeled) in hypertension (see Chapter 5). (PgDn key for more text) * Hypertrophic cardiomyopathy (unlabeled): Verapamil is fre- quently useful. Nifedipine and diltiazem are also effective in selected patients. * Other indications (unlabeled): Nifedipine is effective in the treatment of some cases of Raynaud's phenomenon. Verapamil has been used to treat insulinoma-induced hypoglycemia. * Hypersensitivity: (uncommon) * CV: verapamil and diltiazem are contraindicated in sick sinus syndrome or AV conduction defect (in the absence of a pacemaker), and in severe hypotension as in cardiogenic shock. Warning: Congestive heart failure may be worsened by verapamil or diltiazem. (Home to return to top of file)

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