Calan: Advanced Calcium Channel Blockade for Cardiovascular Health
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| Product dosage: 240mg | |||
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Calan (verapamil hydrochloride) is a premium calcium channel blocker medication specifically engineered for the management of hypertension, angina pectoris, and certain cardiac arrhythmias. Developed through rigorous pharmaceutical research, it represents a cornerstone in cardiovascular therapeutic strategies. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac cells, Calan effectively reduces peripheral vascular resistance and myocardial oxygen demand. This expert-level formulation is trusted by cardiologists worldwide for its proven efficacy in stabilizing heart rhythm and blood pressure, offering patients a path toward improved cardiac function and long-term health management.
Features
- Active ingredient: Verapamil hydrochloride
- Available in immediate-release and extended-release tablet formulations
- Standard strengths: 40 mg, 80 mg, 120 mg, 180 mg, 240 mg
- Selective inhibition of L-type calcium channels
- High oral bioavailability with extensive first-pass metabolism
- Hepatic cytochrome P450 metabolism (primarily CYP3A4)
Benefits
- Effectively lowers elevated blood pressure, reducing long-term cardiovascular risk
- Decreases frequency and severity of angina attacks by improving myocardial oxygen supply-demand ratio
- Restores normal sinus rhythm in certain supraventricular tachyarrhythmias
- Provides 24-hour blood pressure control with extended-release formulations
- Demonstrates protective effects against vascular remodeling
- Offers flexible dosing regimens for individualized patient management
Common use
Calan is predominantly prescribed for the management of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is equally effective in treating chronic stable angina and vasospastic (Prinzmetal’s) angina. In cardiology practice, it is frequently utilized for heart rate control in atrial fibrillation and flutter, as well as for the prevention of recurrent paroxysmal supraventricular tachycardia. Off-label applications include migraine prophylaxis, hypertrophic cardiomyopathy management, and reduction of ventricular rate in digitalized patients with atrial fibrillation.
Dosage and direction
Dosage must be individualized based on therapeutic response and tolerability. For hypertension: Initial dose typically ranges from 80-120 mg three times daily (immediate-release) or 180-240 mg once daily (extended-release), with maximum daily dose not exceeding 480 mg. For angina: 80-120 mg three times daily. For arrhythmias: 240-480 mg daily in divided doses. Administration with food may minimize gastrointestinal upset. Extended-release tablets must be swallowed whole, not crushed or chewed. Regular blood pressure monitoring is essential during dosage titration. Elderly patients or those with hepatic impairment require lower initial doses and careful titration.
Precautions
Patients should undergo comprehensive cardiac assessment before initiation, including electrocardiogram to rule out pre-existing conduction abnormalities. Regular monitoring of blood pressure, heart rate, and ECG intervals (particularly PR interval) is mandatory. Use with caution in patients with impaired hepatic function—dose reduction may be necessary. Gradual withdrawal is recommended to avoid rebound hypertension or angina exacerbation. Patients should be advised about potential constipation and appropriate dietary measures. Caution is warranted in patients with neuromuscular transmission disorders (myasthenia gravis, Duchenne muscular dystrophy). Periodic liver function tests are advisable during long-term therapy.
Contraindications
Calan is contraindicated in patients with severe left ventricular dysfunction, sick sinus syndrome or second- or third-degree AV block (except with functioning pacemaker), atrial flutter or fibrillation with accessory pathway (e.g., WPW syndrome), hypotension (systolic pressure <90 mmHg), cardiogenic shock, and known hypersensitivity to verapamil. Concomitant use with ivabradine is strictly contraindicated. Should not be administered to patients with severe hepatic impairment (Child-Pugh class C). Contraindicated in pregnancy unless potential benefit justifies potential risk to fetus.
Possible side effect
Most common adverse reactions include constipation (7-25%), dizziness (3.3-5.5%), nausea (2.7-4.5%), hypotension (2.5-5.0%), headache (1.9-4.5%), and peripheral edema (1.9-5.1%). Less frequently reported: fatigue, bradycardia, flushing, AV block, heart failure exacerbation, elevated liver enzymes. Rare but serious: syncope, cutaneous reactions including Stevens-Johnson syndrome, gingival hyperplasia, galactorrhea, parkinsonism. Most side effects are dose-dependent and often diminish with continued therapy or dose adjustment.
Drug interaction
Calan demonstrates significant pharmacokinetic and pharmacodynamic interactions. Potent inhibitors of CYP3A4 (ketoconazole, clarithromycin, ritonavir) increase verapamil concentrations. Concomitant use with beta-blockers may result in additive negative chronotropic, inotropic, and dromotropic effects. Enhances effects of neuromuscular blocking agents. Increases digoxin concentration by 50-75%—monitor levels closely. Concomitant use with disopyramide or flecainide may cause excessive myocardial depression. Potentiates effects of antihypertensive agents. Reduces lithium clearance. Rifampin significantly decreases verapamil bioavailability. Use with colchicine requires extreme caution.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never double the dose to make up for a missed one. For extended-release formulations, consistency in dosing time is particularly important to maintain stable plasma concentrations. If multiple doses are missed, patients should contact their healthcare provider for guidance on resumption of therapy, as dose adjustment may be necessary.
Overdose
Verapamil overdose primarily manifests as profound hypotension, bradycardia, and conduction abnormalities including complete heart block. Other symptoms include confusion, drowsiness, nausea, vomiting, metabolic acidosis, hyperglycemia, and non-cardiogenic pulmonary edema. Management requires intensive cardiovascular support including IV calcium gluconate or chloride, vasopressors (norepinephrine preferred), atropine for bradycardia, and cardiac pacing if needed. Glucagon may be beneficial. Hemodialysis is not effective due to high protein binding. Gastric lavage may be considered if presentation is early. All suspected overdoses require immediate medical attention and continuous cardiac monitoring.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in original container. Protect from light and moisture. Keep tightly closed. Do not store in bathroom or other areas with high humidity. Keep all medications out of reach of children and pets. Do not use if tablets show evidence of discoloration or physical deterioration. Properly dispose of expired or unused medication through medication take-back programs or according to FDA guidelines.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Calan is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary. Patients should not alter their dosage or discontinue treatment without consulting their physician. The complete prescribing information should be reviewed before initiating therapy. Healthcare providers should consider official prescribing information and current clinical guidelines when making treatment decisions.
Reviews
Cardiologists consistently report positive experiences with Calan, noting its reliable efficacy in hypertension and arrhythmia management. Clinical studies demonstrate 70-80% of hypertensive patients achieve blood pressure control with verapamil monotherapy. Patients frequently report improved exercise tolerance and reduced angina frequency. Some note constipation as a manageable side effect with proper dietary adjustments. Long-term users appreciate the cardiovascular protective effects and stable therapeutic response. The extended-release formulation receives particular praise for its convenience and steady 24-hour coverage. Overall satisfaction rates remain high among both prescribers and patients when used according to appropriate clinical guidelines.