|
Class of Drug | Name | Characteristics | Adverse effects | Interaction with Cyclosporine (CyC) |
|
Calcium Channel Blockers | | | | |
| Nifedipine | Counteract CyC (and possibly TAC) induced vasoconstriction | Edema, Headache, tachycardia, erythema, gingival hyperplasia | − − |
| Isradipine | Idem | Idem | − − |
Dihydropyridines | Felodipine | Idem | Idem | − − |
Amlodipine | Idem | Idem | ± |
| Nicardipine | Idem | Idem | ++ |
| Lercanidipine | Idem | Less edema | ± |
Nondihydropyridines | Diltiazem HCL | Moderate power, reduces coronary vasculopathy after heart transplant | Edema, headache | ++ |
Verapamil HCL | Less vasodilatory power, potentiates immunosuppression? | Constipation, bradycardia, AV block | ++
|
Beta Blockers | Atenolol Bisoprolol Metoprolol | May reduce Cyc-induced headache Useful when concomitant cardiac disease is present | Bradycardia, bronchospasm | − − |
| Nebivolol | Idem + Nitric Oxide release vasodilation | | |
Alpha-beta blockers | Labetalol | Effective oral and intravenous administration | Bradycardia, Orthostatic hypotension | − − |
Carvedilol | Extended release formulation allow once daily use | Bradycardia, bronchospasm | − − |
| Enalapril | Limited efficacy with once daily use | Hyperkalemia, Hyperazotemia Nongap Metabolic Acidosis Dry Cough | − − |
ACE Inhibitors | Lisinopril | Effective along with diuretics may limit renal fibrosis | Idem | − − |
Perindopril Zofenopril | Idem + allow once daily use | Idem | |
Thiazide or Thiazide—like diuretics | Hydrochlorothiazide Indapamide | Counteract sodium retention, potentiate other anti-AH drugs | Prerenal azotemia, Hyperuricemia Hypokalemia Hyponatremia | − − |
Chlortalidone | Idem + better 24-h profile, lowers nocturnal BP | Idem | |
Loop Diuretics | Furosemide | Strong, short action | Hypokalemia, hypomagnesemia | − − |
Torasemide | Sustained action | Idem | − − |
| Minoxidil | K-channel opener. Use with loop diuretics and BBs to minimize adverse effects | Pericardial effusion, Tamponade, Angina pectoris | − − |
Centrally acting vasodilators | Clonidine | Alpha-2 adrenergic and imidazoline-1 receptor agonist | Sedation, dry mouth | − − |
| Moxonidine | Imidazoline type 1 receptor agonist. Promotes natriuresis | Sedation, dry mouth. | − − |
|