Known interactions

A/T/S, Accubron Syrup, Accurbron, Acebutolol, Acetaminophen and Butalbital, Achillea, Achillea millefolium, Activated Charcoal, Actonel with calcium, Advicor, Akne Mycin Ointment, Alendronate and cholecalciferol, All Heal, Allegra, Allegra-D, Almotriptan, Altocor, Altoprev, Amber Touch-and-Heal, Aminophylline (Theophylline) Injection, Aminophylline Tablets, Amitone, Amlodipine and Atorvastatin, Amobarbital, Amytal, Antispasmodic Elixer, Anturane Capsules, AnturaneTablets, Aquaphyllin, Aquaphyllin Syrup, Arduan, Asmalix, Asmalix Elixir, Atenolol, Atenolol and Chlorthalidone, Atenolol Injection, Atorvastatin, Atracurium, Atretol, Atropine, Hyoscyamine, Phenobarbital, and Scopolamine Oral, Atropine, Hyoscyamine, Phenobarbital, and Scopolamine Elixir, Axert, Axocet, Azucacaa, Bellacane SR, Belladonna Alkaloids, Ergotamine, and Phenobarbital Tablets, Bellaspas, Bellergal-S, Betaxolol Ophthalmic, Betaxolol Oral, Betimol, Betoptic, Betoptic S, Biaxin, Biaxin Suspension, Biaxin XL, Bird Lime, Black ginger, Blocadren, Bloodwort, Brevibloc, Bronkodyl, Bucet, Bupap, BuSpar, Buspirone, Butabarbital, Butabarbital Oral Elixir, Butex Forte, Butisol, Butisol Elixir, Caduet, Cal-Citrate, Calcifediol, Calciferol, Calciferol Injection, Calciferol Oral Solution, Calcijex, Calcitriol, Calcitriol Injection, Calcitriol Solution, Calcium Acetate, Calcium Acetate Capsules or Gelcaps, Calcium Carbonate Tablets, Calcium Citrate, Calcium chloride, Calcium disodium versenate, Calcium Gluconate, Calcium Lactate, Calcium Salts, Calcium Salts injection, Calderol, Caltrate 600, Canton ginger, Capim Doce, Carbamazepine, Carbamazepine ER, Carbamazepine Suspension, Carbatrol, Cardioquin, Carteolol, Carteolol Ophthalmic, Cartrol, Catapres, Catapres-TTS, Cephadyn, Cerebyx, CharcoAid, Charcoal, Charcoal capsules, Charcoal Plus, Charcoal powder or oral suspension, CharcoCaps, Cimetidine, Cimetidine Injection, Cimetidine Liquid, Citracal, Citracal Liquitabs, Citrus Calcium, Clarithromycin, Clarithromycin Suspension, Clonidine, Clonidine injection, Clonidine Patch, Co Q 10, Cochin ginger, Coenzyme Q-10, Common ginger, Common Periwinkle, Corgard, Corzide, Cosopt, Crataegus laevigata, Crataegus monogyna, Crataegus oxyacantha, Creeping Myrtle, Cyclosporine, Cyclosporine Injection, Cyclosporine Ophthalmic, Cyclosporine Oral Solution, Dantrium, Dantrium IV, Dantrolene, Dantrolene Injection, Devil's Claw, Devil's Fuge, Devil's Leaf, DHT, DHT Intensol Solution, Dicarbosil, Digitek, Digoxin, Digoxin Injection, Digoxin Liquid, Dihydrotachysterol, Dihydrotachysterol Oral Solution, Dilantin, Dilantin Infatab, Dilantin Injection, Dilantin Kapseals, Dilantin-125, Dofetilide, Dolgic, Donnatal, Donnatal Elixir, Dorzolamide and Timolol Ophthalmic, Doxacurium, Drisdol, Drisdol Oral Solution, Duraclon injection, E.E.S, E.E.S Oral Suspension, Elixomin, Elixomin Elixir, Elixophyllin, Elixophyllin Elixir, Emgel, Ephedra, Ephedra sinica, Epitol, Epitonin, Equetro, Equilet, ERYC, Ergocalciferol, Vitamin D2, Ergocalciferol, Vitamin D2 Injection, Ergocalciferol, Vitamin D2 Oral Solution, Erva Doce, Erygel, EryPed, EryPed Oral Suspension, EryTab, Erythrocin, Erythrocin Lactobionate, Erythromycin Chewable Tablets, Erythromycin ER, Erythromycin Lactobionate Injection, Erythromycin Ophthalmic Ointment, Erythromycin Oral Suspension, Erythromycin Tablets, Capsules, and Extended-Release, Erythromycin Topical, Esmolol, Ethotoin, Etomidate, European Mistletoe, Eyebalm, Ezetimibe and Simvastatin, Fexofenadine, Fexofenadine and Pseudoephedrine, Fluoxetine and Olanzapine, Fluoxetine capsules (Sarafem), Fluoxetine Oral Solution, Fluoxetine tablets or capsules, Folergot-DF, Fosamax Plus D, Fosphenytoin, fluoxetine delayed-release capsules, Garden ginger, Gengraf, Gengraf Solution, Gingembre, Ginger, Golden Bough, Goldenseal, Grapple Plant, Green Arrow, Ground Raspberry, Hagedorn, Halcion, Hardhay, Harpagophytum procumbens, Haw, Hawthorn, Hedgethorn, Herb de la Croix, Herbal Ecstasy, Hyosophen Elixer, Hypericum, Hypericum perforatum, Hytakerol, Ilotycin, Imber, Imipramine, Imipramine HCl, Imipramine Pamoate, Inderal, Inderal IV, Jamaican ginger, Kaa Jhee, Kerlone Oral, Ketek, Klamath Weed, Lanophyllin, Lanophyllin Elixir, Lanoxicaps, Lanoxin, Lanoxin Injection, Lanoxin Liquid, Lansoprazole, Clarithromycin and Amoxicillin, Latanoprost; 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Using of Calan SR

Brand Name(s): Calan SR, Covera-HS, Isoptin SR, Verelan, Verelan PM

Generic Name Verapamil Extended-release

What are verapamil sustained-release tablets or capsules?

VERAPAMIL (Calan® SR, Covera-HS®, Isoptin® SR, Verelan®, Verelan®-PM) is a calcium-channel blocker. It affects the amount of calcium found in your heart and muscle cells. This results in relaxation of blood vessels, which can reduce the amount of work the heart has to do. Sustained-release verapamil helps reduce high blood pressure (hypertension) It is not a cure. Generic verapamil sustained-release tablets are available. It is not a good idea to change the brand of your sustained-release product. Your body may respond differently. If you do switch between products you will need careful supervision from your prescriber or health care professional.

What should my health care professional know before I take verapamil?

They need to know if you have any of these conditions:

  • constipation problems
  • difficulty swallowing (or narrowing of the esophagus)
  • heart or blood vessel disease
  • heart rhythm disturbances such as sick sinus syndrome, ventricular arrhythmias, Wolff-Parkinson-White syndrome, or Lown-Ganong-Levine syndrome
  • liver or kidney disease
  • neuromuscular disease such as muscular dystrophy
  • slow or irregular heartbeat
  • stomach problems (obstruction)
  • an unusual or allergic reaction to verapamil, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I take this medicine?

Take verapamil sustained-release tablets or capsules by mouth. Follow the directions on the prescription label. Swallow the tablets or capsules with a drink of water. Do not take with grapefruit juice. Sustained-release tablets (except Covera-HS® tablets) can be broken in half, but do not crush or chew the tablets. If you are taking Verelan® extended-release capsules, the capsule may be opened and the medicine poured into a small amount of applesauce. Stir well and swallow without chewing. Take this medicine with food to reduce stomach upset. Take your doses at regular intervals. Covera-HS® tablets and Verelan® PM capsules are designed to be taken at bedtime only, do not take at other times of the day. Do not take your medicine more often then directed. Do not stop taking except on your prescriber's advice.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Elderly patients over 65 years old may have a stronger reaction to this medicine and need smaller doses.

What if I miss a dose?

If you miss a dose, take it as soon as you can. Covera®-HS tablets should only be taken once in 24 hours at bedtime; call your prescriber or health care professional for advice if you forget a dose. For other tablets or capsules, if it is almost time for your next dose (less than 8 hours) take only that dose. Do not take double or extra doses.

What drug(s) may interact with verapamil?

Do not take Verapamil with any of the following:

  • astemizole
  • cisapride
  • disopyramide
  • dofetilide
  • grapefruit juice
  • pimozide
  • terfenadine

Verapamil may also interact with the following medications:

  • alcohol
  • alfuzosin
  • alosetron
  • antiinflammatory drugs (NSAIDs, such as ibuprofen)
  • barbiturates such as phenobarbital
  • bosentan
  • caffeine
  • certain antibiotics (clarithromycin, erythromycin, telithromycin, troleandomycin)
  • certain medicines used to treat cancer
  • certain medicines to treat migraine (ergotamine, dihydroergotamine, methysergide)
  • cevimeline
  • cilostazol
  • cimetidine
  • clonidine
  • cyclosporine
  • fentanyl
  • galantamine
  • herbal or dietary supplements such as ginger, gingko biloba, ginseng, hawthorn, ma huang (ephedra), melatonin, St. John's wort, went yeast
  • lithium
  • local anesthetics or general anesthetics
  • medicines for anxiety or difficulty sleeping (examples: alprazolam, buspirone, midazolam, triazolam)
  • medicines for depression or mental problems (examples: imipramine, fluoxetine, fluvoxamine, nefazodone, ziprasidone)
  • medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)
  • medicines for heart-rhythm problems (amiodarone, digoxin, flecainide, procainamide, quinidine)
  • medicines for high cholesterol (atorvastatin, cerivastatin, colesevelam, lovastatin, simvastatin)
  • medicines for high blood pressure or heart problems
  • medicines for HIV infection or AIDS
  • medicines for prostate problems
  • medicines for seizures (carbamazepine, clonazepam, ethosuximide, oxcarbazepine, phenobarbital, phenytoin, primidone, zonisamide)
  • methadone
  • methylprednisolone
  • rifampin, rifabutin or rifapentine
  • sildenafil
  • sirolimus
  • sulfinpyrazone
  • tacrolimus
  • theophylline or aminophylline
  • water pills (diuretics)
  • yohimbine
  • zafirlukast
  • zileuton

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking verapamil?

Side effects that you should report to your prescriber or health care professional as soon as possible:

More common:

  • dizziness
  • slow heartbeat (less than 50 beats per minute)
  • lightheadedness
  • swelling of the legs or ankles

Rare or uncommon:

  • difficulty breathing
  • fast heartbeat, palpitations, irregular heartbeat, chest pain, or
  • fainting
  • skin rash

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • constipation
  • facial flushing
  • headache
  • nausea, vomiting
  • sexual dysfunction
  • weakness or tiredness

What should I watch for while taking verapamil?

Check your blood pressure and pulse rate regularly; this is important while you are taking verapamil. Ask your prescriber or health care professional what your blood pressure and pulse rate should be and when you should contact him or her.

If you are taking the Covera®-HS brand of verapamil, you must take the tablets exactly as prescribed. These tablets are designed to release your medicine at a special time, so that you get the most beneficial effect when you get up in the morning. Do not take the tablets at other times unless your prescriber or health care professional tells you to.

You may feel dizzy or lightheaded. Do not drive, use machinery, or do anything that needs mental alertness until you know how verapamil affects you. To reduce the risk of dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Alcohol can make you more dizzy or increase flushing and rapid heartbeats. Avoid alcoholic drinks.

Do not suddenly stop taking verapamil. Ask your prescriber or health care professional how to gradually reduce the dose.

If you are going to have surgery, tell your prescriber or health care professional that you are taking verapamil.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15 and 25 °C (59 and 77 °F). Protect from light and moisture. Keep container tightly closed.

(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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