calan tablet

کیلن گولی

Written by Dr. Nabeera [PharmD, DOW University Of Health Sciences (DUHS)], Karachi, Pakistan.

Brand name:

Calan

Generic name:

Verapamil HCl

Available dosage forms and their doses:

Available in tablet form in 40 mg and 80 mg doses.

Price:

• 40 mg 1 bottle, which contains 50 tablets, price is Rs. 172.5

• 80 mg tablet box

• 240 mg tablet box (calan SR)

Therapeutic class:

Calcium channel blocker (non-dihydropyridine)

Pharmacological class:

L-type calcium channel blocker in the heart and blood vessels.

Manufacturer:

The Searle Company Ltd

Storage:

• To be stored below 30 degrees Celsius.

• Protect from light, moisture, and heat.

• Keep out of children’s reach.

Prescription drug?

Yes

Mechanism of action:

Inhibition of calcium ion influx through channels into conductive and contractile myocardial cells and vascular smooth muscle cells.

Indications and dosages:

• Hypertension (mild to moderate)

• Renal hypertension

• Management and prophylaxis of Angina Pectoris

• Treatment and management of paroxysmal supraventricular tachycardia

• To reduce the ventricular rate in atrial fibrillation/flutter

For Hypertension:

Initially, 120 mg two times a day, increasing to 160 mg two times a day (if necessary). For

some cases, up to 480 mg daily divided dose is also used.

For Angina:

120 mg three times a day. If patients have angina of effort, then an 80 mg dose three times a day can also be sufficient. For variant angina, less than 120 mg three times a day may not be effective.

Supraventricular tachycardia:

40-120 mg three times a day.

Pediatric population:

Up to 2 years: 20 mg two to three times a day.

Above 2 years: 40-120 mg two to three times a day.

Elderly: -

The above-recommended dose, unless they have renal or liver function impairment.

Side effects:

• Immune system disorders: allergic reactions

• Nervous system disorders: headache, dizziness, paraesthesia, tremor,

extrapyramidal syndrome, dystonia

• Ear and labyrinth disorders: vertigo, tinnitus

• Cardiac disorders: bradycardic, arrhythmias, 2nd, and 3rd-degree AV block,

palpitations, tachycardia, development of heart failure, hypotension

• Vascular disorders: flushing, peripheral edema

• GI disorders: nausea, vomiting, constipation, ileus, abdominal pain

• Skin and subcutaneous tissue disorders: alopecia, ankle edema, Quincke’s

edema, Steven-Johnson syndrome, erythema multiforme, erythromelalgia,

purpura

• Musculoskeletal and connective tissue disorder: muscle weakness, myalgia and

arthralgia

• Reproductive system and breast disorder: erectile dysfunction, gynaecomastia

• General disorder: Fatigue

Interactions:

• Alcohol

• Acetyl salicylic acid

• Alpha-blockers (Prazosin and Terazosin)

• Antiarrhythmics (Flecainide, Quinidine,

• Anticonvulsants (Carbamazepine and Phenytoin)

• Antidepressants (Imipramine)

• Antidiabetics (Glibenclamide)

• Antihypertensives, diuretics, and vasodilators

• Anti-infectives (Rifampicin, Erythromycin, Clarithromycin, Telithromycin)

• Antineoplastics (Doxorubicin)

• Barbiturates (Phenobarbital)

• Benzodiazepines and other anxiolytics (Buspirone and Midazolam)

• Beta-blockers (Metoprolol and Propranolol)

• Cardiac glycoside (Digitoxin and Digoxin)

• Colchicine

• H2 receptor antagonist (Cimetidine)

• HIV antiviral agents (Ritonavir)

• Immunosuppressants (Ciclosporin, Everolimus, Sirolimus, and Tacrolimus)

• Inhaled anesthetics

• Lipid-lowering agents (Atorvastatin, Simvastatin and Lovastatin)

• Lithium

• Metformin

• Neuromuscular blocking agents

• Serotonin receptor agonists (Almotriptan)

• Theophylline

• Uricosurics (Sulfinpyrazone)

• Anticoagulants (Dabigatran etexilate)

• Other cardiac therapy (Ivabradine)

• Others (St. John’s Wort and Grapefruit)

Pregnancy:

Avoid in the first trimester, unless essential.

Lactation:

Only use if essential, otherwise, avoid.

Precautions:

• For patients with liver disease, careful dose titration is recommended.

• For renal impairment patients, monitoring should be done.

• For patients with bradycardia or first-degree AV block, it should be used with

caution.

• For patients with incipient cardiac failure, Verapamil should be given only after

controlling cardiac failure.

• For hypertension treatment, the blood pressure should be monitored at regular

intervals.

• For patients taking HMG CoA reductase inhibitors, caution should be exercised.

Start with the lowest possible dose.

• For patients with neuromuscular transmission diseases, caution should be

exercised.