Calan: Advanced Calcium Channel Blocker for Hypertension Control
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Calan (verapamil hydrochloride) is a premium calcium channel blocker medication specifically formulated for the management of hypertension, angina, and certain cardiac arrhythmias. Developed through rigorous pharmaceutical research, Calan works by inhibiting calcium ion influx across cardiac and vascular smooth muscle cell membranes, resulting in reduced peripheral vascular resistance and decreased myocardial oxygen demand. This comprehensive formulation represents a cornerstone in cardiovascular therapy, offering physicians a trusted option for patients requiring precise blood pressure control and antianginal protection. The extended-release formulation ensures 24-hour therapeutic coverage with once-daily dosing convenience, supporting long-term treatment adherence and consistent cardiovascular protection.
Features
- Contains verapamil hydrochloride as the active pharmaceutical ingredient
- Available in extended-release tablets (120mg, 180mg, 240mg strengths)
- Once-daily dosing regimen for optimal patient compliance
- Specialized gastrointestinal therapeutic system for controlled drug release
- Manufactured under cGMP standards ensuring pharmaceutical purity
- Bioequivalent to reference listed drug with consistent pharmacokinetic profile
- Shelf-stable formulation with protective blister packaging
- scored tablets for accurate dose titration when medically appropriate
Benefits
- Provides sustained 24-hour blood pressure control through consistent calcium channel blockade
- Reduces frequency and severity of angina episodes by decreasing myocardial oxygen demand
- Helps maintain normal sinus rhythm in certain supraventricular tachyarrhythmias
- Offers convenient once-daily dosing that supports long-term treatment adherence
- Demonstrates well-established safety profile with decades of clinical use
- May provide renal protective effects in hypertensive patients through blood pressure normalization
Common use
Calan is primarily prescribed for the management of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also indicated for the treatment of chronic stable angina pectoris and vasospastic (Prinzmetal’s) angina when conventional antianginal therapy proves insufficient. Additionally, Calan is utilized in the management of certain supraventricular tachyarrhythmias, including atrial fibrillation and atrial flutter, where it helps control ventricular rate. Physicians may also consider off-label uses for migraine prophylaxis and hypertrophic cardiomyopathy management based on individual patient assessment and clinical evidence.
Dosage and direction
The recommended initial dosage for hypertension or angina management is 180 mg once daily in the morning. Depending on therapeutic response and tolerability, dosage may be titrated upward to 240 mg, 360 mg, or 480 mg administered once daily. For arrhythmia management, dosing may be initiated at 120-240 mg daily in divided doses, with careful monitoring of cardiac conduction. Tablets should be swallowed whole with a glass of water, without crushing, chewing, or dividing, to maintain the extended-release properties. Administration with food may help minimize potential gastrointestinal discomfort. Dose adjustments are necessary for patients with hepatic impairment, elderly patients, or those with compromised renal function.
Precautions
Patients should undergo thorough cardiovascular assessment before initiating therapy, including electrocardiographic evaluation to exclude pre-existing conduction abnormalities. Regular monitoring of blood pressure, heart rate, and clinical response is essential during dosage titration. Hepatic and renal function should be assessed periodically, particularly in patients with pre-existing organ impairment. Caution is advised when prescribing to elderly patients due to potential age-related decreases in hepatic and renal function. Patients should be advised about the potential for dizziness or lightheadedness, especially during initial therapy or dosage adjustments. Grapefruit juice should be avoided as it may significantly increase verapamil plasma concentrations.
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), hypotension (systolic pressure <90 mmHg), or cardiogenic shock. Concurrent administration with strong CYP3A4 inhibitors that may significantly elevate verapamil levels is contraindicated. Patients with known hypersensitivity to verapamil or any component of the formulation should not receive this medication. The combination with beta-blockers is generally contraindicated in patients with significant ventricular dysfunction or conduction abnormalities.
Possible side effects
Common adverse reactions include constipation (approximately 7-12%), dizziness (3-5%), nausea (2-3%), hypotension (2-3%), headache (2-4%), and peripheral edema (1-2%). Less frequently reported effects include fatigue, bradycardia, flushing, and AV block. Serious but rare adverse events include heart failure exacerbation, marked bradycardia, hepatotoxicity, and severe skin reactions. Most side effects are dose-dependent and often diminish with continued therapy or appropriate dosage adjustment. Patients experiencing persistent or severe adverse effects should seek medical evaluation promptly.
Drug interaction
Calan demonstrates significant interaction potential due to CYP3A4 metabolism. Concomitant use with beta-blockers may potentiate negative chronotropic and inotropic effects. Co-administration with digoxin may increase digoxin serum concentrations by 50-75%, requiring dosage adjustment and monitoring. Statins metabolized by CYP3A4 (atorvastatin, simvastatin) may experience increased exposure. Verapamil may increase concentrations of cyclosporine, carbamazepine, and theophylline. Potent CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) may significantly increase verapamil levels. Concurrent use with disopyramide or flecainide should generally be avoided.
Missed dose
If a dose is missed, patients should take it 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 administration. Consistent daily dosing is important for maintaining stable blood pressure control, so patients should be encouraged to establish a routine for medication administration. If multiple doses are missed, medical consultation is recommended before resuming therapy.
Overdose
Verapamil overdose may produce severe hypotension, bradycardia, and conduction abnormalities including complete heart block. Other manifestations include confusion, drowsiness, nausea, and diminished cardiac output. Management requires immediate medical attention with continuous cardiac monitoring. Treatment is primarily supportive, including intravenous fluids and vasopressors for hypotension, atropine for bradycardia, and calcium gluconate administration to counteract calcium channel blockade. In severe cases, temporary cardiac pacing may be necessary. Gastric lavage may be considered if presentation is early after ingestion. Hemodialysis is not effective due to extensive protein binding.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) with excursions permitted between 15-30°C (59-86°F). Protect from moisture and excessive heat. Keep in the original container with the lid tightly closed. Do not remove desiccant from the packaging. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly discard any medication that appears discolored, damaged, or shows signs of moisture exposure.
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, and treatment decisions should be based on comprehensive medical evaluation. Patients should not adjust dosage or discontinue medication without consulting their physician. The complete prescribing information should be consulted before initiating therapy.
Reviews
Clinical studies demonstrate that Calan provides effective blood pressure reduction in 70-80% of hypertensive patients, with mean systolic reductions of 10-15 mmHg and diastolic reductions of 8-12 mmHg. Angina patients experience approximately 40-60% reduction in attack frequency and nitrate consumption. Cardiologists consistently rate verapamil as a valuable option for patients requiring heart rate control alongside blood pressure management. Patient satisfaction surveys indicate high adherence rates due to the once-daily formulation and generally favorable side effect profile compared to other antihypertensive classes. Long-term follow-up studies confirm maintained efficacy and safety over years of continuous therapy.