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Calan (Verapamil) is in a class of drugs called calcium channel blockers. Verapamil relaxes (widens) blood vessels (veins and arteries), which makes it easier for the heart to pump and reduces its workload.

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Uses

Verapamil (ver AH pa mill) is used to treat hypertension (high blood pressure), angina (chest pain), and to control some types of irregular heartbeats. It relaxes your blood vessels so your heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart to control chest pain (angina). If taken regularly, Verapamil controls chest pain, but it does not stop chest pain once it starts. Your doctor may give you a different medication to take when you have chest pain. This medication is sometimes prescribed for other uses; ask your doctor for more information.

How to take

Take this medication by mouth with or without food, usually three times daily or as directed by your doctor. Verapamil may cause an upset stomach. Take Verapamil with food or milk. Swallow the tablet whole. Do not crush or chew the tablet. Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. For the treatment of high blood pressure, it may take up to a week before the full benefit of this drug takes effect. If used for angina, this medication must be taken regularly to be effective. It should not be used to treat angina when it occurs. Use other medications (e.g., sublingual nitroglycerin) to relieve an angina attack as directed by your doctor. Consult your doctor for details. Do not suddenly stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped.

Side effects

Side effects from Verapamil generally are mild and transient. It can cause dizziness, weakness or fainting because of a slow heart rate or low blood pressure. Other side effects include swelling of the lower extremities, rash, headache, and constipation. Verapamil also can cause mildly abnormal liver tests that usually return to normal with discontinuation of the medication. Verapamil may reduce the heart rate. Verapamil also can cause excessive lowering of blood pressure in rare instances. Verapamil can aggravate heart failure, especially in patients with poor function of their heart muscle. Tell your doctor if any of these symptoms are severe or do not go away: constipation, dizziness or lightheadedness, headache upset stomach, heartburn, excessive tiredness, flushing (feeling of warmth), slow heartbeat, vivid, unusual dreams. If you experience any of the following symptoms, call your doctor immediately: swelling of the face, eyes, lips, tongue, arms, or legs, difficulty breathing or swallowing, fainting, rash yellowing of the skin or eyes, fever, increase in frequency or severity of chest pain (angina) Symptoms of a Verapamil overdose include dizziness, weakness, chest pain, shortness of breath, fainting, an unusually fast or slow heartbeat, coma, slurred speech, and confusion. If you suspect an overdose of Verapamil, seek medical attention immediately.

Precaution

Before taking Verapamil, tell your doctor if you are allergic to Verapamil or any other drugs. Tell your doctor what prescription and nonprescription medications you are taking, especially aspirin, carbamazepine (Tegretol); cyclosporine (Neoral, Sandimmune); fentanyl (Duragesic); heart and blood pressure medications such as beta-blockers, digoxin (Lanoxin), disopyramide (Norpace), flecainide (Tambocor), quinidine (Quinaglute, Quinidex), diuretics ('water pills'), or any other blood pressure lowering medication; lithium (Eskalith, Lithobid); medications to treat depression; medications to treat glaucoma (increased pressure in the eye); phenobarbital; rifampin (Rifadin, Rimactane); theophylline (Theo-Dur); and vitamins. Tell your doctor if you have or have ever had heart, liver, or kidney disease, muscular dystrophy, gastrointestinal obstruction (strictures), other diseases of the heart or blood vessels such as: sick sinus syndrome, aortic stenosis, heart failure, heart block, Wolff-Parkinson-White syndrome, coronary artery disease, or low blood pressure. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Verapamil, call your doctor. If you are having surgery, including dental surgery, tell your doctor or dentist that you are taking Verapamil. You should know that Verapamil may increase the effects of alcohol and make them last longer.

Drug interactions

Concurrent use of Verapamil with a beta blocker (another class of medications that slow heart rate) can occasionally cause profound and dangerous heart slowing. Verapamil can raise the levels of some drugs in blood including digoxin (Lanoxin), theophylline (Slo-Bid), and carbamazepine (Tegretol). Therefore, monitoring of the levels of these drugs is important to avoid toxicity. Verapamil may reduce blood levels of Lithium in some patients. For unclear reasons some patients who took both Verapamil and Lithium have noticed increased side effects of Lithium without increases in their blood levels of Lithium.

Missed dose

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

Storage

Store at room temperature 15° to 30°C (59° to 86° F) in tight, light- resistant container.