Calan (verapamil hydrochloride) is a premium calcium channel blocker medication specifically formulated for the management of hypertension, angina, and certain cardiac arrhythmias. Developed through advanced pharmaceutical research, Calan works by inhibiting calcium ions from entering vascular smooth muscle and cardiac muscle cells, resulting in relaxed blood vessels and reduced cardiac workload. This mechanism provides clinicians with a powerful tool for cardiovascular management while offering patients a well-tolerated treatment option with established efficacy profiles. The medication represents a cornerstone in cardiovascular pharmacotherapy with decades of clinical validation supporting its use in appropriate patient populations.

Features

• Contains verapamil hydrochloride as the active pharmaceutical ingredient
• Available in immediate-release (80 mg, 120 mg) and extended-release formulations (120 mg, 180 mg, 240 mg)
• Film-coated tablets for improved swallowability and taste masking
• Manufactured under strict GMP standards ensuring consistent potency and purity
• Thermo-stable formulation maintains integrity across various climate conditions
• Precisely calibrated release profiles for predictable pharmacokinetics

Benefits

• Effectively lowers blood pressure by reducing peripheral vascular resistance
• Decreases myocardial oxygen demand through reduced afterload and heart rate
• Provides antianginal effects by improving coronary blood flow and reducing cardiac workload
• Offers rhythm control in certain supraventricular tachyarrhythmias
• Demonstrates favorable safety profile with extensive clinical experience
• Available in multiple formulations allowing for personalized treatment regimens

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. Additionally, Calan is utilized in the management of certain supraventricular tachyarrhythmias, including atrial fibrillation and atrial flutter, for ventricular rate control. Off-label uses may include migraine prophylaxis, hypertrophic cardiomyopathy management, and Raynaud’s phenomenon, though these applications require careful medical supervision.

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). Maximum daily dose should not exceed 480 mg. For angina: Initial dose of 80-120 mg three times daily, with maintenance doses typically between 240-480 mg daily in divided doses. For arrhythmias: Dosage varies significantly based on specific condition, typically starting with 80-120 mg every 6-8 hours. Tablets should be swallowed whole with a full glass of water, with or without food consistently. Dose titration should occur at weekly intervals under medical supervision.

Precautions

Patients should be monitored for potential development of hypotension, particularly during initial titration. Regular assessment of liver and kidney function is recommended during long-term therapy. Caution is advised in patients with impaired hepatic function, as verapamil metabolism may be reduced. Patients should avoid abrupt discontinuation, which may precipitate rebound hypertension or angina. Grapefruit juice should be avoided as it may increase verapamil concentrations. Use with caution in patients with neuromuscular transmission disorders such as Duchenne muscular dystrophy or myasthenia gravis. Regular dental care is recommended due to potential gingival hyperplasia.

Contraindications

Calan is contraindicated in patients with severe left ventricular dysfunction, sick sinus syndrome or second- or third-degree AV block (unless a functioning ventricular pacemaker is present), hypotension (systolic pressure <90 mmHg), cardiogenic shock, atrial flutter or fibrillation with an accessory bypass tract (WPW or LGL syndromes), and known hypersensitivity to verapamil or any component of the formulation. Concomitant use with ivabradine is contraindicated. Should not be administered to patients with severe hepatic impairment.

Possible side effect

Common side effects (≥1%) include constipation (7.3%), dizziness (3.3%), nausea (2.7%), hypotension (2.5%), headache (2.2%), edema (1.9%), and fatigue (1.7%). Less frequent adverse reactions include flushing, bradycardia, AV block, heart failure, rash, and elevated liver enzymes. Rare but serious side effects include hepatotoxicity, gingival hyperplasia, erythema multiforme, and parkinsonian symptoms. Most side effects are dose-dependent and often diminish with continued therapy or dose adjustment.

Drug interaction

Calan exhibits numerous clinically significant interactions. Potentiates effects of other antihypertensive agents, increasing hypotension risk. Concomitant use with beta-blockers may result in excessive bradycardia and AV conduction disturbances. Increases serum levels of digoxin, theophylline, cyclosporine, and carbamazepine. CYP3A4 inhibitors (ketoconazole, erythromycin) increase verapamil concentrations. Rifampin and other CYP inducers may decrease efficacy. Enhances effects of neuromuscular blocking agents. Concomitant use with disopyramide or flecainide should be avoided. Interacts with statins, particularly simvastatin and lovastatin.

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, if missed and remembered within 12 hours, take immediately; if beyond 12 hours, skip and resume normal schedule. Consistent timing is important for maintaining stable blood levels, particularly for hypertension control.

Overdose

Verapamil overdose can be life-threatening, primarily manifesting as hypotension, bradycardia, and conduction abnormalities. Symptoms may include dizziness, syncope, confusion, dyspnea, and severe hypotension. Management includes gastric lavage if presented early, activated charcoal, and comprehensive supportive care. Calcium gluconate (1 g IV) may reverse hemodynamic effects. Vasopressors such as dopamine or norepinephrine may be required for hypotension. Atropine may be used for bradycardia. Temporary cardiac pacing may be necessary for severe conduction disturbances. Hemodialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container with the lid tightly closed. Protect from light, moisture, and excessive heat. Keep out of reach of children and pets. Do not transfer tablets to other containers as this may affect stability. Do not use if the blister pack is damaged or tablets show signs of deterioration. Proper disposal of expired or unused medication is essential—do not flush down toilet or drain. Consult pharmacy for appropriate disposal methods.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Calan is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to medication may vary, and only a physician can determine appropriate treatment based on specific medical circumstances. Patients should not alter dosage or discontinue medication without consulting their healthcare provider. The manufacturer is not responsible for consequences resulting from the use or misuse of this information.

Reviews

Clinical studies demonstrate Calan’s efficacy with 70-80% of hypertensive patients achieving blood pressure control. In angina management, studies show significant reduction in attack frequency and nitrate consumption. Cardiologists report favorable experiences with Calan for rate control in atrial fibrillation, noting particular effectiveness in patients with coexistent hypertension. Patient satisfaction surveys indicate good tolerability, though some report constipation as a limiting factor. Long-term studies confirm maintained efficacy with consistent dosing. The extended-release formulation receives particularly positive feedback for improved compliance and reduced side effect profile compared to immediate-release versions.