ReviewDrugs & aging2020
Calcium Channel Blockers Co-prescribed with Loop Diuretics: A Potential Marker of Poor Prescribing?
Review in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 12 citations in OpenAlex.
- Dihydropyridine Calcium Channel Blocker-induced Prescribing Cascades: Signal Detection using High-throughput Sequence Symmetry Analysis.medRxiv : the preprint server for health sciences · 2026Article
- Antihypertensive Drug Use and COVID-19 Disease Severity in Hospitalized US Veterans: A Retrospective Cohort Study.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Article
- Amlodipine and frusemide: pharmacological factors contributing to increased fall risk in concurrently treated patients - a retrospective cross-sectional study.Frontiers in pharmacology · 2025Article
- Analysis of Blood Components and Target Prediction for the Combined Use ofDrug design, development and therapy · 2025Article
- Polypharmacy Is Associated with Sociodemographic Factors and Socioeconomic Status in United States Adults.Pharmacy (Basel, Switzerland) · 2024Article
- Evaluating Provider and Pharmacy Discordance in Potential Calcium Channel Blocker-Loop Diuretic Prescribing Cascade.Drugs & aging · 2024Article
- Prescribing Cascades: How to Detect Them, Prevent Them, and Use Them Appropriately.Deutsches Arzteblatt international · 2022Review
- An examination of three prescribing cascades in a cohort of older adults with dementia.BMC geriatrics · 2021Article
- Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation.Journal of clinical hypertension (Greenwich, Conn.) · 2020Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prescribing cascades are where a drug adverse reaction is wrongly attributed to the emergence of a new condition, which leads to further drug prescribing. This promotes polypharmacy, adverse drug reactions and therapeutic burden. An example of a prescribing cascade is the co-prescribing of loop diuretics to treat the peripheral oedema caused by calcium channel blocker (CCB) drugs. Although well recognised, this is still a combination of medications taken by millions of people worldwide. CCBs have no prognostic benefit in heart failure and have an absolute risk increase for oedema of around 8-18% (number needed to harm 6-13). In the treatment of hypertension, they also increase the risk of oedema and a new diagnosis of heart failure without having any major advantages over alternative drugs. The best way to manage the oedema caused by CCBs is to switch to an alternative medication. Only where this is not possible or fails to achieve therapeutic goals would the CCB-loop diuretic combination appear to be justified. In many cases, therapeutic practice could be improved by targeting people on CCB-loop diuretic combinations for medication review. This could improve quality of life and reduce polypharmacy, adverse drug reactions, therapeutic burden and financial costs for millions of people worldwide.
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