Calcium antagonists for cardiovascular disease

Calcium antagonists (calcium channel blockers) are an ever widening group of drugs used mainly in the treatment of cardiovascular disease. Verapamil, nifedipine and diltiazem1 were the first to be introduced and different formulations of these continue to be marketed. The fourth member of the group was nicardipine,2 followed since by amlodipine,3 isradipine, felodipine and lacidipine. In this article we compare and contrast oral preparations of the calcium antagonists and consider the choice when treating patients with angina pectoris, myocardial infarction, hypertension and cardiac arrhythmias. Nimodipine,4 which has a specific use in the treatment of patients with subarachnoid haemorrhage, will not be considered.