CALCIUM CHANNEL BLOCKERS

Brand & Generic Names

Adalat	Isoptin SR
Adalat CC	ISRADIPINE
Adalat FT	NICARDIPINE
Adalat P.A.	NIFEDIPINE
Apo-Diltiaz	NIMODIPINE
Apo-Nifed	Nimotop
Apo-Verap	Norvasc
Bepadin	Novo-Diltazem
BEPRIDIL	Novo-Nifedin
Calan	Novo-Veramil
Calan SR	Nu-Diltiaz
Cardene	Nu-Nifed
Cardizem	Nu-Verap
Cardizem CD	Plendil
Cardizem SR	Procardia
Chase	Procardia XL
Dilacor-XR	Renedil
DILTIAZEM	Sibelium
Dyna Circ	Syn-Diltiazem
FELODIPINE	Vascor
FLUNARIZINE	VERAPAMIL
Isoptin	Verelan

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Calcium channel blocker, antiarrhythmic, antianginal

Uses

• Prevents angina attacks.
• Stabilizes irregular heartbeat.
• Treats high blood pressure.

Dosage & Usage Information

How to take:
Tablet or capsule: Swallow with liquid. You may chew or crush tablet.
Extended-release tablets or capsules: Swallow each dose whole with liquid; do not crush.

When to take:
At the same times each day. Take verapamil with food.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Reduces work that heart must perform.
Reduces normal artery pressure.
Increases oxygen to heart muscle.

Time lapse before drug works:
1 to 2 hours.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Unusually fast or unusually slow heartbeat, loss of consciousness, cardiac arrest.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, give mouth-to-mouth breathing. If there is no heartbeat, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Tiredness.

Infrequent:

• Unusually fast or unusually slow heartbeat, wheezing, cough, shortness of breath.
• Dizziness; numbness or tingling in hands and feet; swollen feet, ankles or legs; difficult urination.
• Nausea, constipation.

Rare:

• Fainting, depression, psychosis, rash, jaundice.
• Headache, insomnia, vivid dreams, hair loss.

Warnings & Precautions

Don't take if:

• You are allergic to calcium channel blockers.
• You have very low blood pressure.

Before you start, consult your doctor:

• If you have kidney or liver disease.
• If you have high blood pressure.
• If you have heart disease other than coronary artery disease.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Risks to unborn child outweigh benefits. Don't use.

Breast-feeding:
Safety not established. Avoid if possible. Consult doctor.

Infants & children:
Not recommended.

Prolonged use:
Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure, liver function, kidney functions, ECG*.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Avoid if you feel dizzy. Otherwise, no problems expected.

Discontinuing:
Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:
Learn to check you own pulse rate. If it drops to 50 beats per minute or lower, don't take drug until you consult your doctor.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
ACE inhibitors*:	Possible excessive potassium
captopril, enalapril,	in blood. Dosages may
lisinopril	require adjustment.
Antiarrhythmics*	Possible increased effect and
	toxicity of each drug.
Anticoagulants, oral*	Possible increased anticoagulant
	effect.
Anticonvulsants, hydantoin*	Increased anticonvulsant effect.
Antihypertensives*	Blood pressure drop. Dosages
	may require adjustment.
Beta-adrenergic blockers*	Possible irregular heartbeat and
	congestive heart failure.
Calcium (large doses)	Possible decreased effect of
	channel blocker.
Carbamazepine	May increase carbamzepine effect
	and toxicity.
Cimetidine	Possible increased effect of
	channel blocker.
Cyclosporine	Increased cyclosporine toxicity.
Digitalis preparations*	Increased digitalis effect. May
	need to reduce dose.
Disopyramide	May cause dangerously slow, fast
	or irregular heartbeat.
Diuretics*	Dangerous blood pressure drop.
	Dosages may require adjustment.
Encainide	Increased effect of toxicity on
	heart muscle.
Lithium	Possible decreased lithium effect.
Nicardipine	Possible increased effect and
	of each drug.
Nimodipine	Dangerous blood pressure drop.
Nitrates*	Reduced angina attacks.
Phenytoin	Possible decreased calcium channel
	blocker effect.
Propafenone	Increased effect of both drugs and
	increased risk of toxicity.
Quinidine	Increased quinidine effect.
Rifampin	Decreased effect of calcium channel
	blocker.
Theophylline	May increase effect and toxicity of
	theophylline.
Vitamin D	Decreased effect of calcium channel
	blockers.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Dangerously low blood pressure.
	Avoid.
----------
Beverages:	None expected.
----------
Cocaine:	Possible irregular heartbeat.
	Avoid.
--------
Foods:	None expected.
----------
Marijuana:	Possible irregular heartbeat.
	Avoid.
--------
Tobacco:	Possible rapid heartbeat.
	Avoid.