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.
CALAN SR Contraindications:
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.
CALAN SR Warnings/Precautions:
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.
CALAN SR Classification:
Calcium channel blocker (CCB) (diphenylalkylamine).
CALAN SR Interactions:
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