Authors
A George Koshy, MD, DM, Professor, Department of Cardiology, Medical College, Trivandrum.
Abstract
Calcium Channel Blockers (CCBs) mainly act by vasodilatation and reduction in peripheral vascular resistance. They are one of the most commonly used drugs for the management of systemic hypertension and angina. CCBs are a heterogeneous group of drugs that can chemically be classified into dihydropyridines (DHPs) and the non – DHPs. Their common pharmacologic property is selective inhibition of L – type calcium channel opening in vascular smooth muscle and in the myocardium.
Cilnidipine is a novel and unique 1, 4 – dihydropyridine derivative developed in Japan. Most of the studies with drug are from Japan. It is not approved by US FDA and is not marketed in the US and European countries. It is a dual action calcium channel blocker with action on both L/ N type of calcium channels. It lowers blood pressure by inhibiting L – type calcium channels directly associated with vascular tone. It also inhibits N – type calcium channels, suppressing sympathetic over activity.
Being lipophilic, Cilnidipine has prolonged duration of action and once daily dose effectively control blood pressure throughout 24 hours.
It is indicated in the treatment of Essential hypertension, as monotherapy as well as in combination with other drugs. It is useful in elderly hypertensives and in those with diabetes and albuminuria. It is increasingly used in individuals with chronic kidney disease, alone or in combination with ACE inhibitors/ ARB.
Keywords: Cilnidipine, Long duration action, Indications.