Abstract
Answer A
If either a beta or calcium-channel blocker does not satisfactorily control symptoms, consider the other option (that is, calcium-channel blocker or beta-blocker) or consider using both together. When combining a calcium-channel blocker with a beta-blocker, use a dihydropyridine calcium-channel blocker (e.g. slow-release nifedipine, amlodipine or felodipine).
Diltiazem is effective in angina, and may be used in patients for whom beta-blockers are contra-indicated or ineffective. However, because of the risk of bradycardia, it should be used with caution in association with beta-blockers.
NICE Clinical Guideline 126: Management of Stable Angina www.nice.org.uk/nicemedia/live/13549/55660/55660.pdf
British National Formulary www.bnf.org