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Calan

Calan
Calan Verapamil is a calcium channel blocker. It works by relaxing the muscles in your heart and blood vessels. Verapamil is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders.

Brand: Verapamil

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: September 2023
Package Price Per pill Save Order
Calan 240 mg
270 pills - 240 mg
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$207.77 $0.77 $132.79 Add to cart
180 pills - 240 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$143.53 $0.80 $83.51 Add to cart
120 pills - 240 mg
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$102.93 $0.86 $48.43 Add to cart
90 pills - 240 mg $81.35 $0.90 $32.17 Add to cart
60 pills - 240 mg $58.97 $0.98 $16.71 Add to cart
30 pills - 240 mg $37.84 $1.26 No Add to cart
Calan 120 mg
270 pills - 120 mg
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$127.99 $0.47 $87.38 Add to cart
180 pills - 120 mg $93.65 $0.52 $49.93 Add to cart
120 pills - 120 mg $70.99 $0.59 $24.73 Add to cart
90 pills - 120 mg $59.16 $0.66 $12.63 Add to cart
60 pills - 120 mg $47.86 $0.80 No Add to cart
Calan 80 mg
270 pills - 80 mg
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$100.98 $0.37 $24.87 Add to cart
180 pills - 80 mg $71.99 $0.40 $11.91 Add to cart
90 pills - 80 mg $41.95 $0.47 No Add to cart
Calan 40 mg
270 pills - 40 mg $99.99 $0.37 $22.86 Add to cart
180 pills - 40 mg $70.95 $0.39 $10.95 Add to cart
90 pills - 40 mg $40.95 $0.46 No Add to cart

Product description

Pharmacological action of Calan Verapamil

Buy Calan Verapamil in Canada

Class I selective calcium channel blocker, a diphenylalkylamine derivative. It has antianginal, antiarrhythmic and antihypertensive effects.

The antianginal effect is associated both with a direct effect on the myocardium and with an effect on peripheral hemodynamics (reduces the tone of peripheral arteries, OPSS). The blockade of calcium entry into the cell leads to a decrease in the transformation of energy contained in the high-energy ATP bonds into mechanical work, and a decrease in myocardial contractility. Reduces myocardial oxygen demand, has a vasodilating, negative foreign and chronotropic effect. Increases the period of diastolic relaxation of the left ventricle, reduces the tone of the myocardial wall.

The antihypertensive effect of verapamil may also be due to a decrease in the OPSS.

Verapamil significantly reduces AV conduction, lengthens the refractory period and suppresses the automatism of the sinus node. It has an antiarrhythmic effect in supraventricular arrhythmias.

Pharmacokinetics

When ingested, more than 90% of the dose is absorbed. Protein binding - 90%. Metabolized during the "first pass" through the liver. The main metabolite is norverapamil, which has less pronounced hypotensive activity than unchanged verapamil.

T1/2 when taking a single dose is 2.8-7.4 hours, when taking repeated doses - 4.5-12 hours (due to saturation of the liver enzyme systems and an increase in the concentration of verapamil in the blood plasma). After intravenous administration, the initial T1/2 is about 4 minutes, the final one is 2-5 hours.

It is excreted mainly by the kidneys and 9-16% through the intestines.

Indications of the active substances of the drug Verapamil

Treatment of tachycardia with Calan Verapamil

Treatment and prevention of coronary artery disease: chronic stable angina (exertional angina), unstable angina, vasospastic angina (Prinzmetal angina / variant angina).

Treatment and prevention of cardiac arrhythmias: paroxysmal supraventricular tachycardia, chronic form of atrial flutter and atrial fibrillation (tachyarrhythmic variant), supraventricular extrasystole.

Arterial hypertension. Hypertensive crisis.

Hypertrophic cardiomyopathy.

Dosing regimen of Calan Verapamil

Calan Verapamil drug label

Individual. Inside for adults - at an initial dose of 40-80 mg 3 times / day. For dosage forms of prolonged action, the single dose should be increased and the frequency of administration should be decreased. Children aged 6-14 years - 80-360 mg / day, up to 6 years - 40-60 mg / day; reception frequency - 3-4 times / day.

If necessary, verapamil can be injected intravenously (slowly, under the control of blood pressure, heart rate and ECG). A single dose for adults is 5-10 mg, in the absence of effect after 20 minutes, repeated administration at the same dose is possible. A single dose for children aged 6-14 years is 2.5-3.5 mg, 1-5 years old - 2-3 mg, up to 1 year old - 0.75-2 mg. For patients with severe hepatic dysfunction, the daily dose of verapamil should not exceed 120 mg.

The maximum daily oral dose for adults is 480 mg.

Application during pregnancy and lactation

Contraindicated during pregnancy and lactation.

Application for violations of liver function

Use with caution in case of severe violations of liver function

Application for impaired renal function

Use with caution in case of severe impaired renal function

Use in children

Contraindicated in children under 18 years of age.

Use in elderly patients

Use with caution in elderly patients.

Inelderly patients, the administration is carried out for at least 3 minutes to reduce the risk of unwanted effects.

Special instructions

During treatment, it is necessary to control the function of the cardiovascular and respiratory systems, the content of glucose and electrolytes in the blood, the volume of circulating blood and the amount of urine excreted. May lengthen the PQ interval at plasma concentrations above 30 ng / ml. It is not recommended to stop treatment suddenly.

Influence on the ability to drive vehicles and control mechanisms.

Use with caution during work for drivers of vehicles and people whose profession is associated with increased concentration of attention (reduced reaction rate).

Overdose

Symptoms: sinus bradycardia, turning into atrioventricular block, sometimes asystole, marked decrease in blood pressure, heart failure, shock, sinoatrial block.

Assistance: in case of bradycardia and conduction disturbances - intravenous administration of isoprenaline, atropine, 10-20 ml of 10% calcium gluconate solution, an artificial pacemaker; intravenous infusion of plasma-substituting solutions. To increase blood pressure in patients with hypertrophic obstructive cardiomyopathy, alpha-adrenostimulants (phenylephrine) are prescribed; isoprenaline and norepinephria should not be used. Hemodialysis is not effective.

Drug Interaction

Increases the concentration in the blood of digoxin, theophylline, prazosin, cyclosporine, carbamazepine, muscle relaxants, quinidine, valproic acid due to the suppression of metabolism with the participation of cytochrome P450.

Cimetidine increases the bioavailability of verapamil by almost 40% (due to a decrease in metabolism in the liver), and therefore, it may be necessary to reduce the dose of the latter.

Calcium preparations reduce the effectiveness of verapamil. Rifampicin, barbiturates, nicotine, accelerating the metabolism in the liver, lead to a decrease in the concentration of verapamil in the blood, reduce the severity of antianginal, hypotensive and antiarrhythmic action.

With simultaneous use with inhalation anesthetics, the risk of developing bradycardia, atrioventricular blockade, heart failure increases. Procainamide, quinidine and other drugs that cause prolongation of the QT interval increase the risk of significant QT prolongation.

The combination with beta-blockers can lead to an increase in the negative inotropic effect, an increase in the risk of developing atrioventricular conduction disorders, bradycardia (the administration of verapamil and beta-blockers must be carried out at intervals of several hours).

Prazosin and other alpha-blockers enhance the hypotensive effect. Non-steroidal anti-inflammatory drugs reduce the hypotensive effect due to suppression of prostaglandin synthesis, retention of sodium ions and fluid in the body.

Increases the concentration of cardiac glycosides (requires careful monitoring and dose reduction of cardiac glycosides).

Sympathomimetics reduce the hypotensive effect of verapamil.

Disopyramide and flecainide should not be administered within 48 hours before and 24 hours after the use of verapamil (summation of the negative inotropic effect, up to death).

Estrogens reduce the hypotensive effect due to fluid retention in the body. An increase in plasma concentrations of drugs characterized by a high degree of binding to proteins (including coumarin and indandione derivatives, non-steroidal anti-inflammatory drugs, quinine, salicylates, sulfinpyrazone) is possible.

Medicines that lower blood pressure enhance the hypotensive effect of verapamil.

Increases the risk of the neurotoxic effect of lithium preparations. Enhances the activity of peripheral muscle relaxants (may require a change in the dosage regimen).

Storage conditions of the drug Verapamil

In a dark place at a temperature of 15-25 ° C. Keep out of the reach of children.


Side effects

Sometimes, when taking verapamil in high doses or in the presence of any cardiovascular disorders, the following may occur: arrhythmia against the background of bradycardia (sinus bradycardia, sinoatrial blockade, AV block I, II or III degree or bradyarrhythmia with atrial fibrillation), arterial hypotension , palpitations, tachycardia, development or worsening of symptoms of heart failure.

A fairly frequent occurrence of constipation has been reported when taking the drug inside; in rare cases, nausea, vomiting, bowel obstruction, abdominal pain or discomfort, dizziness or drowsiness, increased fatigue, increased nervousness / tremors, leg edema, erythromelalgia or paresthesia may develop.

In rare cases, dizziness, headache, and hot flashes may occur. In very rare cases, myalgia and arthralgia may occur.

Allergic reactions (exanthema, urticaria, urticaria, angioedema, Stevens-Johnson syndrome) have been rarely reported. A reversible increase in hepatic transaminase and / or ALP levels, an increase in prolactin levels have also been described.

In rare cases, elderly patients with long-term therapy developed gynecomastia, which in all cases was completely reversible after discontinuation of the drug. Cases of galactorrhea and impotence have been reported.

In extremely rare cases, gingival hyperplasia may develop during long-term treatment, which is completely reversible after discontinuation of the drug.