Calcium channel blockers (also called calcium antagonists) are vasodilalors (drugs that relax blood vessels) used to treat primary pulmonary hypertension. They are designed to prevent the entry of calcium ions into the muscle cells of the heart and blood vessels, causing these vessels to widen and relax. As a result, blood pressure is lowered and circulation is improved. Although there are many vasodilators used to treat PPH, calcium channel blockers have been the most widely tested, and appear to be more effective than other vasodilators. Nevertheless, they are only 20% effective in adults and 40% effective in children. An FDA approved drug called Flolan may help critically ill patients who do not respond to treatment with calcium channel blockers such as Adalat (nifedipine). Generally, only tests performed during a heart catheterization can determine definatively whether or not the patients responds to calcium channel blockers.

Types of Calcium blockers include: Adalat (nifedipine), Calan (verapamil), Cardene (nicardipine), Cardizem (diltiazem), Cardizem CD (diltiazem), Cardizem SR (diltiazem), Covera-HS (verapamil), Dilacor XR (diltiazem), Diltia XT (diltiazem), DynaCirc (isradipine), Isoptin (verapamil), Nimotop (nimodipine), Norvasc (amlodipine), Plendil (felodipine), Procardia (nifedipine), Procardia XL (nifedipine), Sular (nisoldipine), Tiamate (diltiazem),Tiazac (diltiazem), Vascor (bepridil), Verelan (verapamil).

The side effects of calcium channel blockers varies greatly depending on the type and dosage prescribed. Possible side effects include the following: constipation, brief headaches, bradycardia (an abnormally slow heart rate), hypotension (low blood pressure), heart block (interupted communication between upper and lower heart chambers), tachycardia (A fast or pounding heartbeat), weakness, gingivitis (swelling or bleeding of the gums), shortness of breath, coughing or wheezing, skin rash, hair loss, swelling (edema) of extremeties, fainting (syncope), lightheadedness, muscle pain, abdominal cramps, nausea, dry mouth, and numbness of extremeties. In rare cases the patient will experience central nervous system imbalance.

Patients should consult their physician before taking any other medication (either prescription or over-the-counter) or nutritional supplements, particularly Antihypertensives (drugs that slow heart rate or lower blood pressure), while using calcium channel blockers. Types of antihypertensives include diuretics, beta blockers, and ACE inhibitors.

Many over-the-counter medications, increase blood pressure and are also considered antihypertensives. Medicines for appetite control, asthma, colds, cough, sinus problems or hay fever should also not be used during calcium blocker treatment with out the consultation of a doctor. Additionally, alcohol, grapefruit juice, recreational drugs (heroin, LSD and marijuana) should be avoided completely during calcium channel blockers use.

Most patients taking calcium channel blockers to PPH will be taking the medication for the rest of their lives, provided no serious side effects occur. Patients should remember that calcium channel blockers may control the symptoms of PHH, but are not a cure for the disease.

Some recent published studies linking calcium channel blockers to breast cancer and heart attacks might also be worth looking into before a patient commits to calcium channel blocker treatment. The NCI (National Cancer Institute) is funding research on calcium channel blockers possible link with breast cancer and a National Heart, Lung, and Blood Institute panel has said that "short-acting nifedipine should be used with great caution (if at all), especially at higher doses, in the treatment of high blood pressure, angina, and myocardial infarction."

Patients should not take calcium channel blockers if they have been diagnosed with any of the following conditions: hypotension (low blood pressure), Congestive heart failure, clinical depression, and Parkinson's disease.


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