Nicardipine, a new
calcium channel blocking drug of the
dihydropyridine family, was administered to 63 patients at a dose of 30 or 40 mg 3 times daily in a multicenter, randomized, double-blind, placebo-controlled, crossover trial.
Nicardipine midly increased heart rate (HR) at rest and midly decreased the blood pressure (BP) at rest. When generally similar responses to the 30- and 40-mg doses were averaged,
nicardipine produced
a 7% increase in peak exercise HR, which was balanced by a 6% decrease in peak exercise BP. Thus, no change occurred in the exercise HR-BP product. With
nicardipine, treadmill exercise duration increased 9%, time to angina increased 15%, time to 1-mm ST-segment depression increased 16%, and oxygen consumption at peak exercise increased 13%. Mean anginal frequency declined, as did mean weekly sublingual
nitroglycerin consumption, but not significantly. There were more cardiovascular side effects with
nicardipine than with placebo, with at least 3 patients having increased angina judged by investigators as probably related to the
drug. Vasodilatory side effects were also more frequent with
nicardipine, but were generally mild and well tolerated; the
drug had to be discontinued in only 1 patient, because of vasodilatory effects.
Nicardipine is effective and generally well tolerated in patients with
chronic stable angina.