The Brand Name CALAPTIN Has Generic Salt :: Verapamil 

CALAPTIN  Is From Company Piramal Hc. Priced :: Rs. 12.68

CALAPTIN have Verapamil is comes under Sub class #N/A of  Main Class #N/A

Main Medicine Class:: #N/A  Sub Medicine Class :: #N/A 

Indications for Drugs ::

Essential hypertension, Angina pectoris and prevention of re-infarction, Supraventricular arrhythmias. Paroxysmal supraventricular tachycardias, Atrial fibrillation with rapid ventricular response (except WPWS) , Atrial flutter with rapid conduction, Extrasystoles, Acute hypertension, Acute coronary insufficiency, For the prophylaxis and / or therapy of ectopic arrhythmias (predominantly ventricular extrasystoles) in halothane anaesthesia and in the application of adrenaline in halothane anaesthesia respectively.

Drug Dose ::

Oral: The dose of Verapamil should be individualized by titration and the drug should be administered with food. For essential hypertension the initial dose should be given 180 mg in the morning. If adequate response is not obtained with 180 mg of Verapamil then the dose may be titrated by following manner: 240 mg each morning. 180 mg each morning plus 180 mg each evening. 240 mg every 12 hourly. For angina the usual dose is 80 mg to 120 mg three times a day. For arrythmias in digitalized patients, Verapamil should be given 240 mg to 360 mg in divided doses, depending on the severity of the condition. Divided doses up to 180 mg/day may occasionally be needed. Intravenous: Adults: 5mg slowly intravenously, in tachycardias and hypertensive crises, if necessary repeat after 5 to 10 minutes. Drip infusion to maintain the therapeutic effect: 5-10 mg/hour in physiological saline, glucose, laevulose or similar solutions, on average up to a total dose of 100mg/day. Children: Newborn 0.75-1mg (= 0.3-0.4ml) Infants 0.75-2mg (= 0.3-0.8ml) Children age 1-5 years: 2-3mg (= 0.8-1.2ml) age 6-14 years: 2.5-5mg (= 1-2ml) of Verapamil, given intravenously, depending on age and action. The injection should be made slowly under electrocardiographic control and only until onset of the effect. Intravenous infusion in hypertensive crises: initially 0.05-0.1mg/kg/hour; if the effect proves to be insufficient, the dose is increased at 30-60 minute intervals until twice the dose or more is reached. Average total dose up to 1.5mg/kg/day.

Contraindication ::

Severe left ventricular dysfunction, hypotension or cardiogenic shockSick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker)Second or third-degree atrioventricular (AV) block (except in patients with a functioning artificial pacemaker)Patients with atrial flutter or atrial fibrillation and an accessory by pass tract(eg. Wolff-Parkinson-White, Lown-Ganong-Levine syndrome)Patients with known hypersensitivity to verapamil hydrochlorideVerapamil injection should not be administered intravenously to patients on beta-blockers (except in an intensive care setting) and known hypersensitivity to Verapamil hydrochloride.

Drug Precautions ::

Care should be taken in 1st degree AV block, bradycardia <50 beats/minutes, hypotension <90 mm Hg systolic pressure, atrial fibrillation/flutter and simultaneous pre-excitation syndrome e.g. WPW syndrome, heart failure (previous compensation with cardiac glycosides/diuretics required).Verapamil may impair ability to drive or operate machinery, particularly in the initial stages of treatment and with concomitant consumption of alcohol. Verapamil markedly slows down the elimination of alcohol and prolongs the duration of the effects of alcohol.Verapamil should be given as a slow intravenous injection over at least 2 minutes under continuous ECG and blood pressure monitoring. Intravenous injection should only be given by the physician.In atrial fibrillation and simultaneous WPW syndrome there is a risk of inducing ventricular fibrillation Drug Side Effects ::

Verapamil is generally well tolerated. The following reaction to orally administered Verapamil appeared clearly drug related or occurred at rates greater than 1% in clinical trials with approximately 5000 patients.Digestive system: Constipation, nausea;Cardiovascular system: Hypotension, edema, CHF, pulmonary edema, bradycardia, AV block;Respiratory system: Upper respiratory tract infections;Nervous system: Dizziness, headache, fatigue;Skin: Rash, flashing;Hepatic: Elevated liver enzyme.

Pregnancy category ::

3

Drug Mode of Action ::  

Verapamil inhibits entry of calcium ions into arterial smooth muscle cells as well as the myocytes and conducting tissue. These actions lead to reversal and preventions of coronary artery spasm, reduction in afterload through peripheral vasodilatation and reduction in ventricular rate in patients with chronic atrial flutter or fibrillation and reduction in the occurrence of paroxysmal supraventricular tachycardia. Verapamil reduces BP, relieves angina and slows AV conduction.

Drug Interactions ::

Increased cardiac depressant effects with ?-blockers and flecainide. Increased risk of additive bradycardia, conduction disturbances and digoxin toxicity with digoxin. Increased risk of bradycardia and hypotension with remifentanil and sufentanil. Increased levels of both everolimus and verapamil on concurrent use. May increase doxorubicin, buspirone, carbamazepine, ciclosporin, epirubicin, eplerenone, quinidine, statins, sirolimus, tacrolimus, quinupristin/dalfopristin levels. Verapamil increase blood alcohol levels. Unpredictable interactions with lithium. Decreased verapamil concentrations with phenobarbital, sulfinpyrazone, rifampicin, rifabutin and rifapentine. Increased verapamil concentrations with protease inhibitors and cimetidine. Potentially Fatal: Increased cardiac depressant effects with amiodarone. Increased risk of QT prolongation with dofetilide, ranolazine, sertindole. Additive bradycardia with ivabradine. Increased risk of heart block with clonidine. Increased risk of acute hyperkalaemia and CV collapse with dantrolene.