Indications for CALAN SR:
Take with food. Initially 180mg in the AM; may titrate to max 480mg/day in divided doses. Elderly or small patients: initially 120mg in the AM.
<18yrs: not established.
Severe left ventricular (LV) dysfunction or LV dysfunction treated with β-blockers. Moderate to severe heart failure. Hypotension. Cardiogenic shock. Sick sinus syndrome, 2nd- or 3rd-degree AV block, unless paced. Atrial flutter or fibrillation and an accessory bypass tract.
Control mild ventricular dysfunction (eg, with digitalis, diuretics) before initiation. AV conduction or neuromuscular transmission disorders. Hepatic or renal impairment. Monitor liver function periodically. Hypertrophic cardiomyopathy. Pregnancy. Nursing mothers: not recommended.
Calcium channel blocker (CCB) (diphenylalkylamine).
Potentiates alcohol, β-blockers, other antihypertensives, digitalis, theophylline, neuromuscular blockers, flecainide, carbamazepine, cyclosporine, lovastatin (limit to max 40mg/day), simvastatin (limit to max 10mg/day), atorvastatin (use lower doses). Avoid ivabradine; quinidine in hypertrophic cardiomyopathy; disopyramide within 48hrs before or 24hrs after verapamil. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir), grapefruit juice; antagonized by CYP3A4 inducers (eg, phenobarbital, rifampin). Inhalation anesthetics may potentiate cardiac depression. May increase bleeding with aspirin. Monitor theophylline, lithium. Concomitant mTOR inhibitors (eg, sirolimus, temsirolimus, everolimus); consider dose reductions of both drugs. Monitor heart rate with concomitant clonidine.
Constipation, dizziness, nausea, hypotension, headache, edema, CHF, fatigue, dyspnea, bradycardia, AV block, rash, flushing, elevated liver enzymes; rare: paralytic ileus.
Calan 80mg, 120mg—100; SR 120mg, 180mg—100; SR 240mg—100, 500