Biochem/physiol Actions

Manidipine is a dihydropyridine class calcium channel blocker (CCB) that exerits its antihypertensive activity via targeting both L-type and T-type calcium channels. In contrary to other dihydropyridines and non-dihydropyridines that mainly act as L-type CCBs, Manidipine diminishes glomerular pressure and, consequently, albumin excretion via its action against T-type channels of efferent arterioles in addition to promoting afferent arteriole dilation by blocking L-type channels. Clinically, Manidipine is as effective in lowering blood pressure as other dihydropyridines, while only Manidipine significantly reduces albuminuria and insulin resistance with less adverse effects. In obese and hypertensive individuals, Manidipine is more effective than Lercanidipine in reducing insulin resistance, while Nifedipine treatment is reported to increase insulin desensitisation.