Drug Interactions of Dihydropyridine Calcium Channel Blockers (CCBs) involving CYP3A4 Enzymes

2019 ◽  
Vol 7 (2) ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 6026-6032

Non-dihydropyridine CCBs such as verapamil and diltiazem are useful in the management of angina, certain arrhythmias and hypertension and they are known inhibitors of CYP3A enzymes and P-gp transporter. Hence, they can potentiate the adverse effects of substrates of CYP3A enzymes and P-gp transporter. This article focuses on the drug interactions of non-dihydropyridine CCBs involving CYP3A enzymes and P-gp transporter protein. To predict and prevent adverse outcomes, the prescribers and the pharmacists are required to be aware of the possible drug interactions of non-dihydropyridine CCBs.


2021 ◽  
Vol 62 (2) ◽  
Author(s):  
Bùi Tùng Hiệp ◽  
Nguyễn Thị Xuân Hoàng ◽  
Đỗ Văn Mãi ◽  
Nguyễn Đức Lộc

Objectives: To assess the current situation of using hypertension drugs for outpatients at the examination department of Hau Nghia Regional General Hospital - Long An. Objects and methods: Study of Cross-sectional description, retrospection, non-intervention on 180 patients who came to examine and treat hypertension at the examination Department, stored on the software of the Hau Nghia Regional General Hospital - Long An. Results: Among the drug groups used to treat hypertension, the group of drugs used the most was calcium channel blockers (58.25%), the lowest was diuretics with 3.88%. The regimens used for patients, the number of regimens using one drug accounted for the largest proportion, accounting for 86.67%. The regimen using 2 drugs accounted for 12.22% and the lowest was the combination regimen of 3 drugs with only 2 patients, accounting for 1.11%. In monotherapy was preferred by the doctor over combination therapy, in which Amlodipine was the most prescribed drug. The number of times of drug use per day of some drugs did not comply with recommendations and drug interactions accounted for a high proportion. Conclusion: The treatment regimen of hypertension was mainly monotherapy with calcium blockers, the most common being Amlodipine. However, the number of drugs used per day of some drugs did not comply with recommendations and drug interactions accounted for a high proportion.


2018 ◽  
Vol 73 (8) ◽  
pp. 2271-2273 ◽  
Author(s):  
Dario Cattaneo ◽  
Tiziana Formenti ◽  
Noemi Astuti ◽  
Paola Meraviglia ◽  
Annalisa Ridolfo ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xinju Zhao ◽  
Chunyan Zhang ◽  
Li Zhu ◽  
Bei Wu ◽  
Yun Han ◽  
...  

Abstract Background Patients with kidney disease may have concurrent hypertension and infection. Dihydropyridine calcium-channel blockers (CCB) are the most popular class of antihypertensive drugs used in clinical settings and can be metabolized by cytochrome P450 isoenzyme 3A4 (CYP3A4). Voriconazole is a commonly used antifungal treatment and a CYP3A4-inhibitor. Insufficient attention to drug interactions from the concomitant use of CCB and voriconazole may result in serious adverse reactions. Case presentation Here, we report a patient with acute kidney injury on stable anti-neutrophil cytoplasm antibody associated vasculitis who developed hyperkalemia resulting in sinus arrest with junctional escape rhythm attributed to drug interactions of CCB with voriconazole. This is a very rarely reported case and may be an under-recognized complication. After continuous renal replacement therapy and changing the anti-hypertensive drugs, symptoms, and laboratory abnormalities of the patient fully recovered. Conclusions This case warns us of severe consequences of drug interactions. Co-prescription of CYP3A4-inhibitors with calcium-channel blockers increases the risk of hypotension and acute kidney injury, which may further induce hyperkalemia and arrhythmia.


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