Calan

Drug Name

Calan (Verapamil)

Drug Uses

This 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 Taken

This 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 Mechanism

Calan 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 Dose

If you miss a dose, take as soon as remembered; do not take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

Storage

Store at room temperature away from sunlight and moisture.

Warnings/Precautions

Before 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.

Possible Side Effects

This 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 Information

Laboratory tests (e.g., liver function tests) should be performed periodically to monitor for side effects. Do not share this medication with others.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Calcium: A mineral found mainly in the hard part of bones, where it is stored. Calcium is added to bones by cells called osteoblasts and is removed from bones by cells called osteoclasts. Calcium is essential for healthy bones. It is also important for muscle contraction, heart action, nervous system maintenance, and normal blood clotting. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1,200 milligrams a day (four glasses of milk) for men and women 51 and older, 1,000 milligrams a day for adults 19 through 50, and 1,300 milligrams a day for children 9 through 18. The upper limit for calcium intake is 2.5 grams daily.

Cavities: Holes in the two outer layers of a tooth called the enamel and the dentin. The enamel is the outermost white hard surface and the dentin is the yellow layer just beneath enamel. Both layers serve to protect the inner living tooth tissue called the pulp, where blood vessels and nerves reside. Small cavities may not cause pain, and may be unnoticed by the patient. Larger cavities can collect food, and the inner pulp of the affected tooth can become irritated by bacterial toxins, foods that are cold, hot, sour, or sweet - causing toothache.

Naturopathy: A system of therapy based on preventative care, and on the use of heat, water, light, air, and massage as primary therapies for disease. Some naturopaths use no medications, either pharmaceutical or herbal. Some recommend herbal remedies only. A few who are licensed to prescribe may recommend pharmaceuticals in those cases where they feel their use is warranted.

Naturopathy is an American healthcare profession. It was founded in the US as a formal healthcare system at the turn of the 20th century by medical practitioners from various natural therapeutic disciplines. By the early 1900s, more than 20 naturopathic medical schools existed, and naturopathic physicians were licensed in most States. Today there are more than 1,000 licensed naturopathic doctors in the US.

As practiced today, naturopathic medicine integrates traditional natural therapeutics -- including botanical medicine, clinical nutrition, homeopathy, acupuncture, traditional oriental medicine, hydrotherapy, and naturopathic manipulative therapy -- with modern scientific medical diagnostic science and standards of care. The medical research base of naturopathic practice consists of empirical documentation of treatments using case history observations, medical records, and summaries of practitioners' clinical experiences.

At present, the two accredited naturopathic medical schools in the US have active research departments. Naturopathic researchers have investigated the pharmacology and physiological effects of nutritional and natural therapeutic agents, and naturopathic physicians have been active in the investigation of new homeopathic remedies and in the natural treatment of women's health problems. The most recently completed naturopathic study in women's health tested the clinical and endocrine effects of a botanical formula as an alternative to estrogen replacement therapy.

Blood: The familiar red fluid in the body that contains white and red blood cells, platelets, proteins, and other elements. The blood is transported throughout the body by the circulatory system. Blood functions in two directions: arterial and venous. Arterial blood is the means by which oxygen and nutrients are transported to tissues while venous blood is the means by which carbon dioxide and metabolic by-products are transported to the lungs and kidneys, respectively, for removal from the body.

Blood pressure: The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle. It's measurement is recorded by two numbers. The first (systolic pressure) is measured after the heart contracts and is highest. The second (diastolic pressure) is measured before the heart contracts and lowest. A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called "hypertension".

Brain: That part of the central nervous system that is located within the cranium (skull). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."

Disease: Illness or sickness often characterized by typical patient problems (symptoms) and physical findings (signs). Disruption sequence: The events that occur when a fetus that is developing normally is subjected to a destructive agent such as the rubella (German measles) virus.

Doctor: In a medical context, any medical professional with an MD, a PhD, or any other doctoral degree. The term doctor is quite nonspecific. A doctor may, for example, be a physician, psychologist, biomedical scientist, dentist, or veterinarian. In a nonmedical context, a professor of history might be addressed as doctor, an eminent theologian might be named a doctor of a church, and a person awarded an honorary doctorate by a college or university might also be called a doctor.

The word "doctor" comes from the Latin "docere" meaning to teach. A doctor was a teacher, especially a learned or authoritative one.