Calcium antagonists (calcium channel blockers)

Wirkungsweise Bluthochdruck Medikament Kalziumantagonist

As a medicine for high blood pressure, calcium antagonists (calcium channel blockers) such as Amlodipine, Diltiazem, Nifedipine, Nitrenidipine, Verapamil and similar drugs are used.

Calcium is an essential mineral because it has many functions in the body. Its best-known role is in the bones: if too little calcium is taken in through the diet or the body cant absorb enough, the risk of osteoporosis increases. But calcium also plays an important role in blood pressure and in the electrical activation and contraction of the heart. It acts as a messenger between cells because it can enter or leave a cell through special channels in the cell membrane. These channels are especially important for blood pressure and the heart. When calcium is released from the storage within a vessel cell, it triggers a chain of reactions that can cause the vessel to narrow and blood pressure to rise.

The effect in the heart is similar. When calcium flows into heart muscle cells, the heart muscle contracts more forcefully. Calcium also affects the hearts electrical system. It especially triggers electrical activity and conduction in the AV node. The faster calcium flows in, the faster the heart beats.

Calcium channel blockers: how they work

Muscle cells need calcium to contract. Calcium channel blockers reduce the flow of calcium into the smooth muscle of the blood vessels. This causes the arteries to widen (dilate) and lowers blood pressure. In heart muscle cells, calcium channel blockers reduce the hearts ability to contract and slow electrical conduction, which leads to a slower pulse.

Calcium channel blockers are divided into 2 main classes depending on their main site of action (some sources list 3):

Dihydropyridines (Amlodipine, Nifedipine): act mainly on the blood vessels
Medications of this type can also be used to help control symptoms of stable angina.
Non-dihydropyridines (Verapamil, Diltiazem): act mainly on the heart and on the generation and conduction of electrical impulses

Diltiazem-type calcium antagonists occupy a special place because they affect several target organs. In addition to being used for high blood pressure, these drugs are also used for stable angina, fast heart rhythm disorders (tachycardias) and atrial fibrillation.

In most cases, calcium antagonists are used in combination with other blood pressure medications.

Calcium channel blockers: side effects

With mainly vessel-acting calcium antagonists of the dihydropyridine type (Amlodipine, Nifedipine), common side effects include fluid retention in the ankles (edema), facial flushing, an increased awareness of the heartbeat (palpitations) and headaches.

With non-dihydropyridine drugs (Verapamil, Diltiazem) constipation and a slower heart rate occur more often
It is important to ensure that treatment with beta blockers and non-dihydropyridine calcium channel blockers (Verapamil, Diltiazem) at the same time is only done by experienced clinicians when specifically necessary. Normally they should not be combined.
For complete information, please read the package leaflet.

Calcium channel blockers: active substances

Amlodipine, Diltiazem, Felodipine, Isradipine, Manidipine, Nifedipine, Nilvadipine, Nisoldipine, Nitrenidipine, Verapamil

Calcium channel blockers: examples of active substances and licensed drugs

Wirkstoff	Produkte
Amlodipin	Amlo TAD, Amlobesilat, Amloclair, Amlodigamma, Amlodipin, Biramlo Kombipräparat, BisoDipin Kombipräparat, Camlostar Kombipräparat, CandeAmlo Kombipräparat, Caramlo Kombipräparat, Copalia Kombipräparat, Dafiro Kombipräparat, Exforge Kombipräparat, LosAmlo Kombipräparat, Norvasc, RamiDipin Kombipräparat, Ramipril Kombipräparat, Ramipril/Amlodipin Kombipräparat, Sevikar Kombipräparat, Stapressial Kombipräparat, Tonotec Kombipräparat, Triveram Kombipräparat, Twynsta Kombipräparat, Viacoram Kombipräparat, Vocado Kombipräparat
Diltiazem	DiltaHexal, Diltiagamma, Diltiazem, Dilzem
Felodipin	Delmuno Kombipräparat, Felocor, Felodipin, Logimat Kombipräparat, Logimax Kombipräparat, Mobloc Kombipräparat, Modip, Triapin Kombipräparat, Unimax Kombipräparat
Isradipin	Lomir, Vascal
Lercanidipin	Carmen Kombipräparat, Corifeo, Ena-Lerca Kombipräparat, EnaCanpin Kombipräparat, Enalapril/Lercanidipin Kombipräparat, Lercanidipin, Lercaprel Kombipräparat, Zaneril Kombipräparat, Zanipress Kombipräparat
Manidipin	Manyper, Vivace Kombipräparat
Nifedipin	Adalat, Aprical, Belnif Kombipräparat, Bresben Kombipräparat, Nif-Ten Kombipräparat, Nifatenol Kombipräparat, Nife-CT, Nifedipin, NifeHexal, Nifical
Nilvadipin	Escor, Nivadil
Nisoldipin	Baymycard
Nitrendipin	Bayotensin, Eneas Kombipräparat, Jutapress, Nitregamma, Nitren-acis, Nitrendipin, Nitrepress
Verapamil	Isoptin, Tarka Kombipräparat, Vera, Veragamma, VeraHexal, Veramex, Verapamil, Veratide Kombipräparat, Veroptinstada

Sources

This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 12/2025).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.

We hope you found the article helpful. For good blood pressure control, it's important to take your medications correctly. Our app BloodPressureDB will gladly remind you when to take them. It also keeps track of your medication supply and notifies you in time when you're running low. This feature is fully available in the free version as well. Get the free app now.