Calcium channel blockers: pharmacology and place in therapy of pediatric hypertension

The calcium channel blockers (CCBs) are a diverse group of antihypertensive medications with variable pharmacokinetics and clinical effects. Although CCBs have been widely applied to the treatment of hypertensive children, da ta regarding the pharmacokinetics, efficacy and safety of these agents in c hildren are extremely limited. In this review we briefly summarize the mech anism of action of CCBs and then summarize pertinent pharmacokinetic inform ation on each of the CCBs commonly used in children, including amlodipine, diltiazem, felodipine. isradipine, intravenous nicardipine, nifedipine and verapamil. Clinically important drug interactions and adverse effects are d iscussed, as well as the potential role of CCBs in renal protection. Availa ble pediatric efficacy and safety data are summarized, and recommendations made regarding the rational use of CCBs in the management of pediatric hype rtension.