Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercanidipine

Refer Verapramil-

 Elevates digoxin,cyclosporin,hence dose must be reduced.

Potentiates action of propanolol (bradycardia and conduction disturbances).

Decreases serum theophyline levels. H-2 recepector blockrs increase plasma concentration of diltiazem.

Angina pectoris,Chronic stable angina,chronic stable angina,essential hypertension,atrial fibrillation and flutter,paraoxymal supraventricular tachycardia.

 Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Flunarizine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Clevidipine butyrate, Lercanidipine

Refer Verapramil-

DILTIAZEM-
 

Generally not serious, rarely requires discontinuation or dosage adjustment
 
CNS-
Dizziness/lightheadedness    7 %,Headache  2  % ,Asthenia    1.7 %,Nervousness,
Sleep disturbances, Psychiatric disturbances,Depression, amnesia, Weakness/shakiness   < 1 %

GASTROINTESTINAL -
 Nausea  2 %,Constipation 7 %,Diarrhea  < 1%, Abdominal discomfort / cramps/dyspepspa, Dry mouth/ Thirst  < 1 %

CARDIOVASCULAR -
Periph.edema  2 %, Bradycardia  1.5%, Hypotension   1% ,      Abnormal ECG     4%
Palpitation  < 1%,Syncope, 1Congestive  Heart failure , Arrhythmias ,Tachycardia ,
Ventricular extrasystole  < 1 %

DERMATOLOGIC -
Dermatitis/rash 1 %,   Pruritis/urticaria   Photosensitivity < 1%  

HEMATOLOGIC-
Leukopenia 1%, Petechiae/pupura/  < 1%
                                                                                                                                 
 OTHER -
Flushing   3%  ,Mituration disorders,dysuria/frequency  1%,Nasal or chest congestion/sinusitis,  Sexual difficulties, Shortness of  breath,dyspepsia, wheezing  < 1%

Effects associated with depression of cardiac conduction (atrioventricular block,tachycardia etc). 
 Patients with sick sinus syndrome,preexisting atrioventricular block, bradycardia.

 Those taking beta-blckrs or digitalis are particularly at risk of developing these reactions.
 Ankle  oedema, headache, hypotension,flushing,nausea,
  GI discomfort,Gynaecomastia.
  Hyperactivity(sometimes associated  with psychiatric symptoms).

Sick sinus syndrome,

2nd or 3rd AV shock.Severe CCF.

Marked bradycardia.

Pregnancy.

Special precations:

Measure heart rate regularly in elderly or those with hepatic or renal impairment.prolonged AV peroids.

Diabetes,hypotension,abrupt withdrawal long term use.

Approved by  FDA in  1982

Angina pectoris,Chronic stable angina,chronic stable angina,essential hypertension,atrial fibrillation and flutter,paraoxymal supraventricular tachycardia

. Dosage:

Individualise dose. 30mg 4 times a day before meals and bed time..

Gradually increase dosage to 180 to 360mg, given in divided doses of 3 to 4 times a day, at 1 or 2 days interval until optimum response is obtained.

Missed dose- 

1. If you miss a dose of this medicine, take it as soon as possible.

2. However, if it is almost time for next dose, skip the missed dose and go back to your regular dosing schedule.

3. Do not double doses.

 Calcium channel blockers-

1.Take the medicine exactly as directed by the physician.

2.Swallow the tablet whole,without crushing or chewing it. However if advosed by the doctor, you may break into half.

3.Take the medicine with food or milk.

Refer - Verapramil- Calcium channel blockers

Refer- Verapramil- Calcium channel blockers

Refer - Verapramil - Calcium channel blockers