Isradipine--another calcium-channel blocker for the treatment of hypertension and angina.
OBJECTIVE
To review the pharmacology, pharmacokinetic disposition, dose recommendations, adverse effects, drug interactions, and efficacy of isradipine in patients with hypertension or ischemic heart disease.


METHODS
Data from scientific literature were extracted, evaluated, and summarized for presentation. A MEDLINE search was conducted using the following indexing terms: isradipine, calcium-channel blockers, hypertension, and angina pectoris. Experiences from studies evaluating isradipine reported in the form of articles, abstracts, or proceedings involving patients or healthy subjects were considered for inclusion.


METHODS
Special consideration was given to clinical studies that had been designed in a blind, randomized fashion. Studies that compared the effectiveness and safety of isradipine with another antihypertensive or antianginal agent or placebo were included.


METHODS
Data from human studies published in the English language were evaluated. Trials were evaluated according to sample size, design, and adequacy of description of therapeutic response.


RESULTS
Isradipine is a new dihydropyridine calcium-channel blocker that appears to exert less negative inotropic activity than nifedipine and to selectively inhibit sinoatrial conduction. Pharmacokinetic parameters are quite variable and considerably more work is needed to better describe the kinetic disposition of isradipine. Antihypertensive efficacy has been demonstrated extensively in a number of short-term trials. Antianginal efficacy also has been observed in a few short-term trials and is comparable to that of isosorbide dinitrate and nifedipine. Extensive experience with isradipine is minimal and no clear-cut advantages over existing compounds have been noted thus far.


CONCLUSIONS
The place of isradipine in the therapy of hypertension and myocardial ischemia is unclear and its routine use cannot yet be recommended based solely on clinical grounds.
Lopez
L M
LM
Department of Pharmacy Practice, College of Pharmacy, University of Florida, Gainesville 32610.
Santiago
T M
TM
D000787:Angina Pectoris / Q000188:drug therapy; D002121:Calcium Channel Blockers / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy* / Q000378:metabolism; D004095:Dihydropyridines / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D004347:Drug Interactions; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D017275:Isradipine; D007668:Kidney / Q000187:drug effects
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D017275:Isradipine