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Atrial fibrillation - Management
What are the adverse effects of calcium-channel blockers, and how should they be managed?
- Verapamil commonly causes constipation.
- Advise the person to eat more fibre (for example 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 may make constipation worse.
- Bradycardia can result from taking diltiazem or verapamil.
- Vasodilatory adverse effects (flushing, headaches, and ankle swelling) are less common with rate-limiting calcium-channel blockers than with dihydropyridine calcium-channel blockers and often improve with continued use. Diuretics should not be routinely prescribed to relieve ankle swelling, but they may help if there is marked oedema.
Basis for recommendation
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