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Angina - stable - Management
What adverse effects are associated with calcium-channel blockers, and how can they be managed?
- Vasodilatory adverse effects (facial flushing, headaches, postural hypotension, and ankle swelling) may occur; they are more common with dihydropyridine calcium-channel blockers (CCBs) than rate-limiting CCBs [Fox et al, 2006a; BNF 57, 2009].
- Vasodilatory effects usually reduce in severity with continued treatment, although ankle swelling often persists.
- Diuretics should not be routinely prescribed for ankle oedema, as they only partially reduce ankle oedema caused by CCBs.
- Verapamil commonly causes constipation [Kumar and Hall, 2003; Eisenberg et al, 2004].
- Advise the person to eat more fibre (such as fruit, vegetables, cereals, and wholemeal bread), to try to drink at least 12 cups (equivalent to eight glasses or eight mugs) of liquid a day, and to avoid drinks with a high caffeine content (because these can make constipation worse).
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