FOCUS ON MIBEFRADIL - A NOVEL SELECTIVE T-TYPE CALCIUM-CHANNEL BLOCKER

Mibefradil represents a drew class of selective T-type channel calcium channel blockers (CCBs) approved for use in the treatment of hyperten sion and, stable angina, Although mibefradil acts principally on arter ial smooth muscle to induce vasodilation, it does not cause reflex tac hycardia or increased sympathetic activity, It causes a decrease in he art rate without negative inotropic effects. In clinical trials, mibef radil was at least as effective as other available CCBs (nifedipine GI TS, amlodipine, diltiazem CD) for the treatment of hypertension and ch ronic stable angina, While the incidence of adverse effects with mibef radil is similar to that with other CCBs, mibefradil may cause less pe ripheral edema and more bradycardia and AV block than certain CCBs (eg , dihydropyridines). Mibefradil can inhibit the P450 3A4 and 2D6 isoen zymes; thus, concurrent administration of hepatically eliminated drugs , such as terfenadine, astemizole, and, cisapride, should be avoided.