Calcium Channel Blocking Agents (Systemic)

Proper Use of This Medicine

Take this medicine exactly as directed even if you feel well and do not notice any signs of chest pain. Do not take more of this medicine and do not take it more often than your doctor ordered. Do not miss any doses.

For patients taking amlodipine :

• Your doctor may suggest that you change your diet and eat foods that are low in salt and fat. Losing weight will help your blood pressure along with your medicine. Talk to your doctor about the best diet for you.

For patients taking bepridil :

• If this medicine causes upset stomach, it can be taken with meals or at bedtime.

For patients taking diltiazem extended-release capsules :

• Swallow the capsule whole, without crushing or chewing it.
• Do not change to another brand without checking with your physician . Different brands have different doses. If you refill your medicine and it looks different, check with your pharmacist.

For patients taking felodipine :

• Do not take this medicine with grapefruit juice.

For patients taking verapamil extended-release capsules :

• Swallow the capsule whole, without crushing or chewing it.

For patients taking felodipine or nifedipine extended-release tablets :

• Swallow the tablet whole, without breaking, crushing, or chewing it.
• If you are taking Adalat XL or Procardia XL , you may sometimes notice what looks like a tablet in your stool. That is just the empty shell that is left after the medicine has been absorbed into your body.
• If you are taking Adalat CC , take the medicine on an empty stomach

For patients taking verapamil extended-release tablets :

• Swallow the tablet whole, without crushing or chewing it. However, if your doctor tells you to, you may break the tablet in half.
• Take the medicine with food or milk.

For patients taking this medicine for high blood pressure :

• In addition to the use of the medicine your doctor has prescribed, appropriate treatment for your high blood pressure may include weight control and care in the types of food you eat, especially foods high in sodium (salt). Your doctor will tell you which factors are most important for you. You should check with your doctor before changing your diet.
• Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
• Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Dosing - The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking calcium channel blocking agents .

For amlodipine
• For oral dosage form (tablets):
  • For angina (chest pain):
    • Adults - 5 to 10 milligrams (mg) once a day.
    • Children - Use must be determined by your doctor.

Note:

Elderly patients or patients determined by your health care professional may be started on a lower dose.

• For high blood pressure:
  • Adults - 5 to 10 mg once a day.
  • Children - Use must be determined by your doctor.

Note:

Elderly patients or patients determined by your health care professional may be started on 2.5 mg once a day.

For bepridil
• For oral dosage form (tablets):
  • For angina (chest pain):
    • Adults - 200 to 300 milligrams (mg) once a day.
    • Children - Use and dose must be determined by your doctor.

For diltiazem
• For long-acting oral dosage form (extended-release capsules):
  • For high blood pressure:
    • Adults and teenagers:
      • For Cardizem CD or Dilacor-XR : 180 to 240 milligrams (mg) once a day.
      • For Cardizem SR : 60 to 120 mg two times a day.
    • Children - Dose must be determined by your doctor.
• For regular (short-acting) oral dosage form (tablets):
  • For angina (chest pain):
    • Adults and teenagers - 30 mg three or four times a day. Your doctor may gradually increase your dose as needed.
    • Children - Dose must be determined by your doctor.
• For injection dosage form:
  • For arrhythmias (irregular heartbeat):
    • Adults and teenagers - Dose is based on body weight and must be determined by your doctor.
    • Children - Use and dose must be determined by your doctor.

For felodipine
• For long-acting oral dosage form (extended-release tablets):
  • For high blood pressure:
    • Adults - 5 to 10 milligrams (mg) once a day.
    • Children - Use and dose must be determined by your doctor.
  • For angina (chest pain):
    • Adults - 10 mg once a day.
    • Children - Use and dose must be determined by your doctor.

For flunarizine
• For oral dosage form (capsules):
  • To prevent headaches:
    • Adults - 10 milligrams (mg) once a day in the evening.
    • Children - Dose must be determined by your doctor.

For isradipine
• For oral dosage form (capsules):
  • For high blood pressure:
    • Adults - 2.5 milligrams (mg) two times a day. Your doctor may increase your dose as needed.
    • Children - Use and dose must be determined by your doctor.

For nicardipine
• For oral dosage form (capsules):
  • For high blood pressure or angina (chest pain):
    • Adults and teenagers - 20 milligrams (mg) three times a day.
    • Children - Dose must be determined by your doctor.

For nifedipine
• For regular (short-acting) oral dosage form (capsules):
  • For high blood pressure or angina (chest pain):
    • Adults and teenagers - 10 milligrams (mg) three times a day. Your doctor may increase your dose as needed.
    • Children - Dose must be determined by your doctor.
• For long-acting oral dosage form (extended-release tablets):
  • For high blood pressure or angina (chest pain):
    • Adults and teenagers:
      • For Adalat CC , Adalat XL or Procardia XL : 30 or 60 mg once a day. Your doctor may increase your dose as needed.
      • For Adalat PA : 10 or 20 mg two times a day. Your doctor may increase your dose as needed.
    • Children - Dose must be determined by your doctor.

For nimodipine
• For oral dosage form (capsules):
  • To treat a burst blood vessel around the brain:
    • Adults - 60 milligrams (mg) every four hours.
    • Children - Dose must be determined by your doctor.

For verapamil
• For regular (short-acting) oral dosage form (tablets):
  • For angina (chest pain), arrhythmias (irregular heartbeat), or high blood pressure:
    • Adults and teenagers - 40 to 120 milligrams (mg) three times a day. Your doctor may increase your dose as needed.
    • Children - Dose is based on body weight and must be determined by your doctor. The usual dose is 4 to 8 mg per kilogram (kg) (1.82 to 3.64 mg per pound) of body weight a day. This is divided into smaller doses.
• For long-acting oral dosage form (extended-release capsules):
  • For high blood pressure:
    • Adults and teenagers - 240 to 480 mg once a day.
    • Children - Dose must be determined by your doctor.
• For long-acting oral dosage form (extended-release tablets):
  • For high blood pressure:
    • Adults and teenagers - 120 mg once a day to 240 mg every twelve hours.
    • Children - Dose must be determined by your doctor.
• For injection dosage form:
  • For arrhythmias (irregular heartbeat):
    • Adults - 5 to 10 mg slowly injected into a vein. The dose may be repeated after thirty minutes.
    • Children - Dose is based on body weight and must be determined by your doctor.
      • Infants up to 1 year of age: 100 to 200 micrograms (mcg) per kg (45.5 to 90.9 mcg per pound) of body weight injected slowly into a vein. The dose may be repeated after thirty minutes.
      • Children 1 to 15 years of age: 100 to 300 mcg per kg (45.5 to 136.4 mcg per pound) of body weight injected slowly into a vein. The dose may be repeated after thirty minutes.

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 dosing schedule. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.