Calcium Channel Blockers include -

Verapramil, Diltiazam, Amlodipine, Nifedipine, Nisodipine, Bepridil, Isradipine

Refer Verapramil

Interacting drugs -summary

Calcium channel blockers+

Betablockers

 coadministration may result in increased adverse effects due to depressant effects on myocardial contractility or AV conduction 

 + Calcium channel blockers

Itraconazole

edema has occured with cocomittant use of itraconazole and amlodipine, nifedipine

Potentiates effects of thiozide diuretics & ACE inhibitors.

Avoid combination with Beta-blockers especially in patients with markedly impaired left ventricular function.

Calcium Channel Blockers include -

Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine,  Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercandipine

 Refer verapramil-
 

AMLODIPINE-
Not serious, rarely requires discontinuation or dosage adjustment

CNS-   Headache   7% Fatigue/lethargy   5%   Dizziness/lightheadedness 3%
            Somnolence   2%   Asthenia     1 % 
             Nervousness , Psychiatric disturbances , Depression, amnesia,
             paranoia,  Psychosis,  hallucinations,  Parathesia, Insomnia,
             Abnormal dreams, Tinnitus , Malaise , Anxiety,
             Tremor/hand tremor  < 1 %    

GASTROINTESTINAL - Nausea  3% ,
                                       Abdomina discomfort, cramps/dyspepsia, 2%,
                                       Diarrhea ,  Hepatitis  Constipation ,Vomiting,
                                       Dry mouth/ thirst , Flatulence < 1% 

CARDIOVASCULAR -  Peripheral edema  12%  Palpitation 5%,
                                       Hypotension, syncope, Bradycardia,
                                       arrhthmias unspecified ,Tachcardia,
                                       Ventricular  < 1%

DERMATOLOGIC -    Dermatitis/rash  , Pruritus.urticaria < 2%

HEMATOLOGIC -       Patechiae/purpura, brusing, hematoma < 1%

OTHER -                     Flushing  4%,
                                    Sexual difficultes , muscle cramps, pain,
                                    Inflammation, joint stiffness, arthiritis, 2%
                                    Muturation disorder, polyuria/nocturia,
                                    Dysuria, frequency,  sweating,weight gain,
                                    Epitaxis, anorexia, < 1%

Known hypersen to dihydropyridines.

Pregnancy.

Special precautions:

Impaired liver or renal function.Elderly.

Safety in pregnancy & lactation,not established

Approved by FDA in July,1992

Hypertension alone or in combination with other antihypertensives, chronic stable angina, vasoplastic angina, Prinzmetals or variant angina alone or in combinations with other antianginals

Dosage:

Usual dose is 5mg once daily. Maximum dose is 10mg daily. Small and elderly patients may be started on 2.5mg once daily.

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.

.

1. Indivudial allergy - Tell your doctor, if you have ever had any unusual or allergic reaction to amlodipine. Also tell your doctor if you are allergic to any other substance, food, or preservatives.

2. Pregnancy - Amlodipine has not been studied in pregnant women. Before taking the medicine make sure that you doctor knows, if you are pregnant or if you may become pregnant.

3. Breast feeding - It is not known whether amlodipine passes into breast milk. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

4. Children - Studies on this medicine have been done only in adults patients, and there is no specific information available comparing use of amlodipine in children with use in other age groups

5. Other medicines - Certain medicines should not be used together due to interactions. However, tell your doctor if you are using any other prescription drugs or over the counter (OTC) medicines.

6. Other medical problems - Tell your doctor, if you have any other medical problems eg. Congestive heart failure,- small chance that amlodipine may make the condition worse, Liver disease- high blood levels of amlodipine may result and a smaller dose may be needed Very low blood pressure- amlodipine may make this condition worse.

7. Dose - Take this medicine as directed by your physician. Do not miss any doses.

8. Missed dose - If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double doses.

9. Storage - Keep out of reach of children. Do not store in the bath room, near the kitchen sink or in damp places. Heat or moisture may cause the medicine to break down.

10. Side effects - Check with your doctor if swelling of ankles or feet occur.

11. Food- Take with or without food

Refer - Verapramil- Calcium channel blockers

Biovailability not affected by food.

Take with or without food

Refer - Verapramil- Calcium channel blockers