Health Guide
Drug Guide

Calcium channel blocker (Oral route, parenteral route)

Brand Names:

Dosage Forms:

Uses of This Medicine:

Amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, and verapamil belong to the group of medicines called calcium channel blocking agents.

Calcium channel blocking agents affect the movement of calcium into the cells of the heart and blood vessels. As a result, they relax blood vessels and increase the supply of blood and oxygen to the heart while reducing its workload.

Some of the calcium channel blocking agents are used to relieve and control angina pectoris (chest pain).

Some are also used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Flunarizine is used to prevent migraine headaches.

Nimodipine is used to prevent and treat problems caused by a burst blood vessel around the brain (also known as a ruptured aneurysm or subarachnoid hemorrhage).

Other calcium channel blocking agents may also be used for these and other conditions as determined by your doctor.

These medicines are available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, calcium channel blocking agents are used in certain patients with the following medical conditions:

Before Using This Medicine:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Although there is no specific information comparing use of this medicine in children with use in other age groups, it is not expected to cause different side effects or problems in children than it does in adults.

Older adults

Elderly people may be especially sensitive to the effects of calcium channel blocking agents. This may increase the chance of side effects during treatment. A lower starting dose may be required.

Pregnancy

Calcium channel blocking agents have not been studied in pregnant women. However, studies in animals have shown that large doses of calcium channel blocking agents cause birth defects, prolonged pregnancy, poor bone development in the offspring, and stillbirth.

Breast-feeding

Although bepridil, diltiazem, nifedipine, verapamil, and possibly other calcium channel blocking agents, pass into breast milk, they have not been reported to cause problems in nursing babies.

Other medicines

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Proper Use of This Medicine:

Take this medicine exactly as directed even if you feel well and do not notice any signs of chest pain. Do not take more of this medicine and do not take it more often than your doctor ordered. Do not miss any doses.

For patients taking amlodipine:

For patients taking bepridil:

For patients taking diltiazem extended-release capsules or tablets:

For patients taking bepridil:

For patients taking felodipine:

For patients taking verapamil extended-release capsules:

For patients taking felodipine or nifedipine extended-release tablets:

For patients taking verapamil extended-release tablets:

For patients taking this medicine for high blood pressure:

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

It is important that your doctor check your progress at regular visits. This will allow your doctor to make sure the medicine is working properly and to change the dosage if needed.

If you have been using this medicine regularly for several weeks, do not suddenly stop using it. Stopping suddenly may bring on your previous problem. Check with your doctor for the best way to reduce gradually the amount you are taking before stopping completely.

Chest pain resulting from exercise or physical exertion is usually reduced or prevented by this medicine. This may tempt you to be overly active. Make sure you discuss with your doctor a safe amount of exercise for your medical problem.

After taking a dose of this medicine you may get a headache that lasts for a short time. This effect is more common if you are taking felodipine, isradipine, or nifedipine. This should become less noticeable after you have taken this medicine for a while. If this effect continues or if the headaches are severe, check with your doctor.

In some patients, tenderness, swelling, or bleeding of the gums may appear soon after treatment with this medicine is started. Brushing and flossing your teeth carefully and regularly and massaging your gums may help prevent this. See your dentist regularly to have your teeth cleaned. Check with your medical doctor or dentist if you have any questions about how to take care of your teeth and gums, or if you notice any tenderness, swelling, or bleeding of your gums,

For patients taking bepridil, diltiazem, or verapamil:

For patients taking flunarizine:

For patients taking this medicine for high blood pressure:

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Not all of the side effects listed below have been reported for each of these medicines, but they have been reported for at least one of them. Since many of the effects of calcium channel blocking agents are similar, some of these side effects may occur with any of these medicines. However, they may be more common with some of these medicines than with others.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common
Breathing difficulty, coughing, or wheezing
irregular or fast, pounding heartbeat
skin rash
slow heartbeat (less than 50 beats per minute bepridil, diltiazem, and verapamil only)
swelling of ankles, feet, or lower legs (more common with amlodipine, felodipine and nifedipine)
Less common
(For flurazine only)
Loss of balance control
mask-like face
mental depression
shuffling walk
stiffness of arms or legs
trembling and shaking of hands and fingers
trouble in speaking or swallowing
Rare
Bleeding, tender, or swollen gums
chest pain (may appear about 30 minutes after medicine is taken)
fainting
painful, swollen joints (for nifedipine only)
trouble in seeing (for nifedipine only)
Rare
(For flunarizine and verapamil only)
Unusual secretion of milk

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Drowsiness (for flunarizine only)
increased appetite and/or weight gain (for flunarizine only)
Less common
Constipation
diarrhea
dizziness or lightheadedness (more common with bepridil and nifedipine)
dryness of mouth (for amlodipine and flunarizine only)
flushing and feeling of warmth (more common with nicardipine and nifedipine)
headache (more common with amlodipine, felodipine, isradipine, and nifedipine)
nausea (more common with bepridil and nifedipine)
unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Last Updated: 6/12/2013

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