Calcium blockers in angina. How they work, when to prescribe.

The calcium channel blocking drugs--nifedipine, verapamil, and diltiazem--are an important adjunct to treatment of typical exertional angina and are the treatment of choice for angina due to coronary artery spasm. These drugs are as effective as nitrates and beta-adrenergic blocking agents in treatment of patients with ischemic heart disease. With certain precautions, they may also be used in combination with nitrates and beta blockers. The three calcium blockers are not completely interchangeable because each has distinctive therapeutic applications and side effects. Detailed knowledge of each drug is important for its intelligent application in treatment of angina pectoris.