Both dihydropyridine (DHP) and non-DHP drugs can be used. Typical average doses of CCBs include verapamil or diltiazem 120 mg in slow-release (sr) formulations given two to three times a day, nifedipine 20–30 mg or twice a day or 10 mg amlodipine once daily. These standard doses of CCBs fully prevent angina attacks in 80–90% of patients.20–25

CCBs at standard doses are usually well tolerated. The most frequent unwanted effect is ankle oedema, with constipation being another bothersome side effect. DHP CCBs may also cause reflex tachycardia and hypotension, which are attenuated when long-acting CCBs (e.g. amlodipine) or sr formulations of short-acting drugs (e.g. nifedipine) are used. Conversely, bradycardia may preclude the use of full doses of non-DHP drugs.

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