Calcium Channel Blockers, SYMPDISEASE

Heart Failure and Calcium Channel Blockers

Angina (chest pain) and high blood pressure are treated with calcium channel blockers. Calcium channel blockers affect the movement of calcium in the heart and blood vessel cells. As a result, calcium channel blockers relax blood vessels, increasing blood and oxygen supply to the heart while decreasing its workload.

These blockers may be used to treat heart failure caused by high blood pressure when other blood pressure-lowering medications are ineffective. Calcium channel blockers should be avoided if you have heart failure caused by systolic dysfunction.

CCB should be avoided in patients with heart failure with reduced ejection fraction (HFrEF) in general because they provide no functional or mortality benefit and some first-generation agents may worsen outcomes. Here, clinical trials evaluating the use of calcium channel blockers in patients with HFrEF will be reviewed. Calcium channel blockers are discussed separately in the treatment of HF with preserved ejection fraction.

Calcium channel blockers include:

How Should I Take Calcium Channel Blockers?

Take CCB food or milk. Follow the directions on the medication label. The number of doses you take each day, the time between doses and the length of time you must take it will be determined by the type of medication prescribed and your condition.

What Side Effects Could I Have From Calcium Channel Blockers?

Side effects of CCB include:

  • Drowsiness
  • Increased appetite
  • Swelling

If these side effects persist or become severe, consult your doctor.

Contact your doctor right away if you experience any of the following side effects.

Should I avoid certain foods or medications while using CCB?

When taking CCB:

• Check with your doctor to see if you should avoid eating grapefruit or drinking grapefruit juice while taking a calcium channel blocker.

  • Alcohol may reduce the effectiveness of calcium channel blockers and increase their side effects.

It is critical that your doctor be aware of any drugs you are taking, since some may interfere with CCB. Consult your doctor before beginning any new medication, including over-the-counter medications, herbs, and vitamins.


Over the last 15 years, significant effort has been made to study the safety and efficacy of (CCBs) in the treatment of patients with persistent congestive heart failure (CHF). Available research indicates that first-generation calcium antagonists may have a negative effect in individuals with CHF, indicating that these medications should be administered with extreme caution in patients with a substantial decrease in left ventricular systolic function.

A number of second-generation CCBs showed a high vasodilatory impact and positive hemodynamic action but did not increase exercise ability, morbidity, or death. Furthermore, medicines like nicardipine and nisoldipine have been shown to be harmful in some people. As a result, when taken in individuals with moderate-to-severe heart failure, it cannot be deemed safe. The data from the V-HeFT III research show that felodipine had no negative effect on exercise tolerance in individuals with chronic heart failure. 


Although the mortality rate was similar in both the felodipine and placebo groups, due to the small number of patients in this study. No firm conclusions can be drawn about the effect of felodipine on mortality in CHF patients. The recently completed PRAISE study provided an encouraging signal regarding the potential role of CCB in the treatment of chronic heart failure. This large-scale prospective trial demonstrated the safety of amlodipine. A long-acting dihydropyridine derivative, in patients with heart failure caused by coronary artery disease. Furthermore, this study demonstrated a significant reduction in mortality in patients with CHF due to nonischemic cardiomyopathy and provided strong evidence for amlodipine’s potential therapeutic benefit when added to standard CHF therapy.