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The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels.

Barnidipine is a lipophilic dihydropyridine calcium-channel blocker, showing high affinity for the calcium channels of the vascular smooth muscle.

The decrease in intracellular calcium inhibits the contractile processes of the systemic arteries smooth muscle cells, and thus, decreases total peripheral resistance and systemic blood pressure. Receptor kinetics of barnidipine are characterised by a slow onset of action and a strong and long-lasting binding; its antihypertensive effect remains during the entire 24-hour dose interval.


  • Mild to moderate essential hypertension

[edit] DOSAGE

Adults and elderly patients: The recommended starting dosage is 10 mg once daily, in the morning. The dosage may be increased to 20 mg once daily if necessary. The decision to increase the dosage should only be taken after complete stability is achieved on the initial dosage. This usually takes at least 3-6 weeks.


  • Hypersensitivity to Barnidipine
  • Hepatic insufficiency.
  • Severe renal dysfunction (creatinine clearance < 10 ml/min).
  • Unstable angina pectoris and acute myocardial infarction (in the first 4 weeks).
  • Untreated heart failure.
  • Blood levels of barnidipine may be increased when used in combination with strong CYP3A4 inhibitors. Therefore, antiproteases, ketoconazole, itraconazole, erythromycin and clarithromycin should not be used concomitantly.




  • No clinical experience with barnidipine in pregnancy or lactation is present. Animal studies do not indicate direct harmful effects with respect to pregnancy, embryonal/foetal or postnatal development. Only indirect effects are observed. The class of dihydropyridines has shown the potential to prolong delivery and parturition, which was not observed with barnidipine. As a consequence, barnidipine could be used in pregnancy only if the benefit justifies the potential risk to the fetus.
  • Lactation: breast feeding is not advised during use of barnidipine


Common side effects are headache, facial redness (Flushing), Peripheral edema, dizziness and palpitations. These symptoms tend to diminish or disappear during treatment


Calcium Channel Blockers Pharmacology


ACE inhibitors Benazepril (Lotensin)   Captopril (Capoten)   Cilazapril   Delapril   Enalapril (Renitec, Vasotec)   Fosinopril (Monopril)  Lisinopril (Prinivil, Zestril)   Moexipril (Univasc)  Perindopril (Aceon)  Quinapril (Accupril)  Ramipril (Altace, Triatec)   Trandolapril (Mavik)  Zofenopril (Bifril, Zopranol)
Angiotensin II receptor antagonist Azilsartan (Edarbi)   Candesartan (Atacand)   Eprosartan (Teveten)   Irbesartan (Aprovel, Avapro, Karvea)   Losartan (Cozaar)   Olmesartan (Benicar, Olmetec)   Telmisartan (Micadis)   Valsartan (Diovan, Tareg)
Renin inhibitors Aliskiren (Rasilez, Tekturna)
Alpha-1 blockers Doxazosin (Cardura)   Prazosin (Minipress)   Terazosin (Hytrin)
Alpha-2 agonists (centrally acting) Clonidine (Oral route)   Clonidine (Transdermal) (Catapresan)   Guanfacine (Tenex)   Methyldopa (Aldomet)
Calcium channel blockers Dihydropyridines‎ Amlodipine (Norvasc)   Barnidipine (Vasexten)   Felodipine (Plendil)   Isradipine (Dynacirc)   Lacidipine (Lacipil, Motens)   Lercanidipine (Zanidip)   Manidipine   Nicardipine   Nifedipine (Adalat)   Nisoldipine   Nitrendipine
Benzothiazepine‎ Diltiazem (Cardizem, Taztia XT, Tiazac, Tildiem)
Phenylalkylamine‎ Gallopamil   Verapamil (Calan)
Beta blockers Beta1 selective (cardioselective) Acebutolol (Sectral)   Atenolol (Tenormin)   Betaxolol (Kerlon)   Bisoprolol (Concor)   Celiprolol (Cordiax)   Metoprolol (Betaloc, Lopressor, Toprol-XL)   Nebivolol (Bystolic, Lobivon, Nebilox)
Nonselective (Beta1 and Beta2 blockers) Oxprenolol (Trasitensin)   Propranolol (Inderal)   Timolol (Blocadren)
Nonselective (Beta1, Beta2 and Alpha1 blockers) Carvedilol (Dilatrend)   Labetalol (Trandate)
Beta blocker with intrinsic sympathomimetic activity (ISA) Acebutolol (Sectral)   Celiprolol (Cordiax)
Lipophilic Beta blockers Propranolol (Inderal)   Metoprolol (Betaloc, Lopressor, Toprol-XL)   Oxprenolol (Trasitensin)
Diuretics Carbonic anhydrase inhibitors Acetazolamide (Diamox)
Loop diuretics Bumetanide   Etacrynic acid   Furosemide (Lasix)   Piretanide   Torasemide (Demadex)
Thiazide diuretics Chlorothiazide (Diuril)   Hydrochlorothiazide (Esidrex)
Thiazide-like diuretics Chlortalidone (Hygroton)   Indapamide (Lozol, Lozide)   Metolazone
Potassium-sparing diuretics Epithelial sodium channel blockers: Amiloride (Midamor)   Triamterene (Dyrenium)
Aldosterone receptor antagonists: Potassium canrenoate   Eplerenone (Inspra)   Spironolactone (Aldactone)
Osmotic diuretics Mannitol
Combination therapy Amiloride/Hydrochlorothiazide (Moduretic)   Spironolactone/Hydrochlorothiazide (Aldactazide)