CALAN SR is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including this drug.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program's Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
DOSAGE AND ADMINISTRATION
The dose of CALAN SR should be individualized by titration and the drug should be administered with food. Initiate therapy with 180 mg of sustained-release verapamil HCl, CALAN SR, given in the morning. Lower initial doses of 120 mg a day may be warranted in patients who may have an increased response to verapamil (eg, the elderly or small people). Upward titration should be based on therapeutic efficacy and safety evaluated weekly and approximately 24 hours after the previous dose. The antihypertensive effects of CALAN SR are evident within the first week of therapy.
If adequate response is not obtained with 180 mg of CALAN SR, the dose may be titrated upward in the following manner:
- 240 mg each morning,
- 180 mg each morning plus
180 mg each evening; or
240 mg each morning plus
120 mg each evening,
- 240 mg every 12 hours.
When switching from immediate-release CALAN to CALAN SR, the total daily dose in milligrams may remain the same.
CALAN SR 120 mg caplets are light violet, oval, film coated, with CALAN debossed on one side and SR 120 on the other, supplied as:
|0025-1901-31||bottle of 100|
CALAN SR 180 mg caplets are light pink, oval, scored, film coated, with CALAN debossed on one side and SR 180 on the other, supplied as:
|0025-1911-31||bottle of 100|
CALAN SR 240 mg caplets are light green, capsule shaped, scored, film coated, with CALAN debossed on one side and SR 240 on the other, supplied as:
|0025-1891-31||bottle of 100|
|0025-1891-51||bottle of 500|
Store at 59° to 77°F (15° to 25°C) and protect from light and moisture. Dispense in tight, light-resistant containers.
Manufactured for: G.D. Searle LLC, Division of Pfizer, Inc, NY, NY 10017. by: (120 mg and 180 mg caplets) Abbott Laboratories, North Chicago, IL 60064, Pfizer, Inc, Caguas, PR 00725 (240 mg caplets) Abbott GmbH & Co. KG, Ludwigshafen, Germany. Distributed by: G.D.Searle Division of Pfizer Inc., NY, NY 10017. Revised October 2013
Last reviewed on RxList: 12/3/2013
This monograph has been modified to include the generic and brand name in many instances.
Additional Calan SR Information
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