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 recommended.
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 heart failure (eg, with digitalis, diuretics). AV conduction or neuromuscular transmission disorders. Hepatic or renal dysfunction. Monitor liver function. Hypertrophic cardiomyopathy. Pregnancy (Cat.C). 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). Potentiated by grapefruit juice. Avoid ivabradine, disopyramide; quinidine in cardiomyopathy. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir); 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 hepatic enzymes, paralytic ileus.
Calan 40mg—100; 80mg—100, 500, 1000; 120mg—100, 1000; SR 120mg, 180mg—100; SR 240mg—100, 500