Drug NameCalan (Verapamil) Drug UsesThis drug is a calcium channel blocker. Calcium is involved in blood vessel contraction and in controlling the electrical impulses within the heart. By blocking calcium, calan relaxes and widens blood vessels and can normalize heartbeats. Calan is used to treat chest pain (angina), high blood pressure or irregular heartbeats. Ask your doctor or pharmacist about possible problems related to use of short-acting calcium channel blockers. How to useThis medication should be swallowed whole with a full glass of water unless your doctor directs you otherwise. This medication must be taken as directed to prevent chest pain. It is not effective if taken only when chest pain occurs. Do not stop taking this medication suddenly without your doctor's permission. Chest pain can occur if the medication is stopped too fast. Your dose may need to be gradually decreased. Drug Class and MechanismCalan belongs to a class of medications, called calcium channel blockers. These medications block the movement of calcium into the muscle cells of the coronary arteries (the arteries supplying the heart) as well as the other arteries of the body. Since calcium is what triggers contraction of muscles, blocking entry of calcium relaxes the arterial muscles. This relaxation allows the arteries to become larger so that more blood can flow through them. Thus, calan is useful in treating and preventing chest pain (angina) resulting from spasm (contraction) of the coronary arteries that reduces the flow of blood to the heart. Relaxing the muscles lining the arteries in the rest of the body lowers blood pressure and thereby reduces the pressure against which the heart must pump blood. As a result, the heart works less and requires less oxygen-carrying blood. This allows the heart to work with the reduced flow of blood caused by coronary artery disease and prevents angina (which occurs whenever the flow of blood to the heart is inadequate). Calan also decreases the conduction of electrical impulses through the heart that control the coordination of contraction. As a result, the rate of contraction slows. Missed DoseIf you miss a dose of Myambutol , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Storage Store at room temperature away from sunlight and moisture. Possible Side EffectsThis drug may cause dizziness and lightheadedness especially during the first few days. Avoid activities requiring alertness. When you sit or lie down for a while, get up slowly to allow your body to adjust and minimize dizziness. You may also experience weakness, fatigue, nausea, muscle cramps, headache, flushing or constipation. These effects should disappear as your body adjusts to the medication. Inform your doctor if they become bothersome. Notify your doctor immediately if you develop: breathing difficulties, swelling of the hands or feet, irregular heartbeat, fever, stomach/abdominal pain, yellowing eyes and skin, dark urine. If you notice other effects not listed above, contact your doctor or pharmacist. More InformationLaboratory tests (e.g., liver function tests) should be performed periodically to monitor for side effects. Do not share this medication with others. Warnings/PrecautionsBefore using this drug, tell your doctor your medical history, including: allergies (especially drug allergies), heart problems (e.g., heart rhythm disturbances, heart failure), liver or kidney disease, very low blood pressure, muscular dystrophy, brain tumors (cancer). Before heart surgery, tell your doctor you use this medicine. Calan prolongs and intensifies the effects of alcohol in your system. Avoid (or very carefully limit) alcoholic beverages while using this medication. Caution is advised when this drug is used in the elderly. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk and a decision should be made whether to stop the drug or avoid breast-feeding. Consult your doctor before breast-feeding.
What is verapamil?
Verapamil is in a group of drugs called calcium channel blockers. It works by relaxing the muscles of your heart and blood vessels.
Verapamil is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders.
Verapamil may also be used for other purposes not listed in this medication guide.
What is the most important information I should know about verapamil?
You should not use this medication if you are allergic to verapamil or if you have certain serious heart conditions such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker), low blood pressure, or if you have recently had a heart attack.
Before taking verapamil, tell your doctor if you are allergic to any drugs, or if you have kidney disease, liver disease, congestive heart failure, or a nerve-muscle disorder such as muscular dystrophy.
Verapamil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Do not stop taking this medication without first talking to your doctor. If you stop taking verapamil suddenly, your condition may become worse.
Verapamil may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely.
If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.
What should I discuss with my healthcare provider before taking verapamil?
You should not use this medication if you are allergic to verapamil, or if you have:
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certain serious heart conditions, especially "sick sinus syndrome" or "AV block" (unless you have a pacemaker);
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low blood pressure; or
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if you have recently had a heart attack.
If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take verapamil, tell your doctor if you have:
FDA pregnancy category C. It is not known whether verapamil is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. Verapamil can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I take verapamil?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results from this medication.
Do not crush, chew, break, or open a controlled-delivery or extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.
If you have trouble swallowing a verapamil capsule whole, ask your doctor or pharmacist if it is safe for you to open the capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.
It is important to use verapamil regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Do not stop taking this medication without first talking to your doctor. If you stop taking verapamil suddenly, your condition may become worse.
If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.
Verapamil may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely.
To be sure this medication is helping your condition, your blood pressure will need to be tested on a regular basis. Your kidney and liver function may also need to be tested. Do not miss any scheduled visits to your doctor.
If you need to have any type of surgery, tell the surgeon ahead of time that you are using verapamil. Store verapamil at room temperature away from moisture, heat, and light.
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include slow heartbeat and fainting.
What should I avoid while taking verapamil?
Verapamil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
Avoid drinking alcohol while taking verapamil.
Grapefruit and grapefruit juice may interact with verapamil and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
Verapamil side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
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fast or slow heartbeats;
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feeling like you might pass out;
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fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
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feeling short of breath, even with mild exertion;
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swelling, rapid weight gain; or
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nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
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constipation, nausea;
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skin rash or itching;
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dizziness, headache, tired feeling; or
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warmth, itching, redness, or tingly feeling under your skin.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.
What other drugs will affect verapamil?
Before taking verapamil, tell your doctor if you are using any of the following drugs:
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any other blood pressure medications;
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buspirone (BuSpar);
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carbamazepine (Carbatrol, Tegretol);
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cimetidine (Tagamet, Tagamet HB);
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cyclosporine (Gengraf, Neoral, Sandimmune);
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digoxin (digitalis, Lanoxin, Lanoxicaps);
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lithium (Eskalith, LithoBid);
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lovastatin (Mevacor);
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phenobarbital (Solfoton);
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rifampin (Rifadin, Rimactane, Rifater);
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theophylline (Elixophyllin, Theo-24, Uniphyl);
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a sedative such as midazolam (Versed) or triazolam (Halcion);
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an antibiotic such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Ery-Tab, Erythrocin), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), telithromycin (Ketek), or voriconazole (Vfend);
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a beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta, Ziac), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others;
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a heart rhythm medication such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), flecainide (Tambocor), or quinidine (Quinaglute, Quinidex, Quin-Release); or
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HIV/AIDS medicine such as amprenavir (Agenerase), atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), or ritonavir (Norvir, Kaletra).
This list is not complete and there may be other drugs that can interact with verapamil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Where can I get more information?
- Your pharmacist can provide more information about verapamil.
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