Dihydropyridines side effects

Short-acting nifedipine may rarely cause an increase in the frequency, intensity, and duration of angina in association with acute hypotension. This effect may be obviated by using sustained-released formulations of nifedipine or other dihydropyridines. Other side effects of dihydropyridines include dizziness, flushing, headache, gingival hyperplasia, and peripheral edema. Side effects due to vasodilation such as dizziness, flushing, head-... 

In clinical trials, lacidipine was found to be a very potent and long-lasting antihypertensive agent a dose of 4 mg emerged as the recommended daily dose to control mild to moderate hypertension. The drug was well tolerated, and the side effects - including headache - were mild in nature and common to those of the other dihydropyridine s. 

Most side effects of the calcium channel blockers are related to their mechanism of action. Verapamil and diltiazem can both cause sinus bradycardia and may worsen CHF. Constipation has been associated with verapamil use. The dihydropyridines often cause symptoms associated with vasodilatation, such as facial flushing, peripheral edema, hypotension, and headache. Because dihydropyridines are potent vasodilators, they can cause reflex tachycardia, which may precipitate palpitations, worsening angina, or Ml. Lastly, all calcium channel blockers can cause Gl complaints and fatigue. 

In the kidney, dihydropyridines have been reported to reduce vasoconstriction on the afferent arterioles without affecting efferent resistance (Loutzenhiser and Epstein, 1985). This profile appears to be unique to the dihydropyridine class since members of the other classes did not have preferential effects on the afferent side. The resulting increase in renal perfusion and glomerular filtration rates leads to improved kidney function. In humans with induced renal insufficiency, nifedipine was shown to improve renal performance (Neumayer et al., 1989 Russo et al., 1990). 

Thus, some derivatives were found to have anxiolytic activity <93YZ400>. A substituted tetra-zoloquinoline compound (90) showed, furthermore, antileishmanial and contragestational effects <89IJC(B)562>. This ring system was also built in as a side chain into 1,4-dihydropyridines <89JMC2297> the derivative (91) showed the pregnancy-interceptive property in mated hamsters. 

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