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Your doctor may increase the dose, if necessary, up to a total of 1800 mg a day. After your condition improves, your doctor may direct you to take a lower dose. Children 2 years of age and older—The dose is based on body weight. At first, 20 mg per kilogram (kg) (about 9 mg per pound) of body weight a day, divided into smaller amounts that are taken three or four times a day. Your doctor may increase the dose, if necessary, up to 30 mg per kg (about 13.5 mg per pound) of body weight a day. After your condition improves, your doctor may direct you to take a lower dose. Children up to 2 years of age—Dose must be determined by your doctor.

Drug Interactions

Other Viagra To Purchases—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When taking calcium channel blocking agents it is especially important that your health care professional know if you are taking any of the following: Acetazolamide (e.g., Diamox) or Amphotericin B by injection (e.g., Fungizone) or Corticosteroids (cortisone-like Viagra To Purchase) or Dichlorphenamide (e.g., Daranide) or Diuretics (water pills) or Methazolamide (e.g., Naptazane)—These Viagra To Purchases can cause hypokalemia (low levels of potassium in the body), which can increase the unwanted effects of bepridil Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Sotacor], timolol [e.g., Blocadren])—Effects of both may be increased. In addition, unwanted effects may occur if a calcium channel blocking agent or a beta-blocking agent is stopped suddenly after both have been used together Carbamazepine (e.g., Tegretol) or Cyclosporine (e.g., Sandimmune) or Procainamide (e.g., Pronestyl) or Quinidine (e.g., Quinidex)—Effects of these medicines may be increased if they are used with some calcium channel blocking agents Digitalis glycosides (heart Viagra To Purchase)—Effects of these medicines may be increased if they are used with some calcium channel blocking agents Disopyramide (e.g., Norpace)—Effects of some calcium channel blocking agents on the heart may be increased Grapefruit juice—Effects of felodipine may be increased. No effects on amlodipine. Also, tell your health care professional if you are using any of the following Viagra To Purchases in the eye: Betaxolol (e.g., Betoptic) or Levobunolol (e.g., Betagan) or Metipranolol (e.g., OptiPranolol) or Timolol (e.g., Timoptic)—Effects on the heart and blood pressure may be increased

Common Brand Names

Some commonly used brand names are: In the U.S.— Adalat7 Adalat CC7 Calan9 Calan SR9 Cardene6 Cardizem2 Cardizem CD2 Cardizem SR2 Dilacor-XR2 DynaCirc5 Isoptin9 Isoptin SR9 Nimotop8 Norvasc10 Plendil3 Procardia7 Procardia XL7 Vascor1 Verelan9 In Canada— Adalat7 Adalat PA7 Adalat XL7 Apo-Diltiaz2 Apo-Nifed7 Apo-Verap9 Cardizem2 Cardizem SR2 Isoptin9 Isoptin SR9 Nimotop8 Norvasc10 Novo-Diltazem2 Novo-Nifedin7 Novo-Veramil9 Nu-Diltiaz2 Nu-Nifed7 Nu-Verap9 Plendil3 Renedil3 Sibelium4 Verelan9 Note: For quick reference, the following calcium channel blocking agents are numbered to match the corresponding brand names. This information applies to the following Viagra To Purchases: 1. Bepridil (BE-pri-dil)† 2. Diltiazem (dil-TYE-a-zem)‡ 3. Felodipine (fe-LOE-di-peen) 4. Flunarizine (floo-NAR-i-zeen)* 5. Isradipine (is-RA-di-peen)† 6. Nicardipine (nye-KAR-de-peen)‡† 7. Nifedipine (nye-FED-i-peen)‡ 8. Nimodipine (nye-MOE-di-peen) 9. Verapamil (ver-AP-a-mil)‡ 10. Amlodipine (am-LOE-di-peen)‡ ‡ Generic name product may be available in the U.S. § Generic name product may be available in Canada * Not commercially available in the U.S. † Not commercially available in Canada

Contraindications

In deciding to use a Viagra To Purchase, the risks of taking Viagra To Purchase must be weighed against the good it will do. This is a decision you and your doctor will make. For the calcium channel blocking agents, the following should be considered: Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, or verapamil. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Pregnancy—Calcium channel blocking agents have not been studied in pregnant women. However, studies in animals have shown that large doses of calcium channel blocking agents cause birth defects, prolonged pregnancy, poor bone development in the offspring, and stillbirth. Breast-feeding—Although bepridil, diltiazem, nifedipine, verapamil, and possibly other calcium channel blocking agents, pass into breast milk, they have not been reported to cause problems in nursing babies. Children—Although there is no specific information comparing use of this Viagra To Purchase in children with use in other age groups, it is not expected to cause different side effects or problems in children than it does in adults. Older adults—Elderly people may be especially sensitive to the effects of calcium channel blocking agents. This may increase the chance of side effects during treatment. A lower starting dose may be required. Other medical problems—The presence of other medical problems may affect the use of the calcium channel blocking agents. Make sure you tell your doctor if you have any other medical problems, especially: Congestive heart failure—Calcium channel blocking agents may make this condition worse Heart rhythm problems (history of)—Bepridil can cause serious heart rhythm problems Kidney disease or Liver disease—Effects of the calcium channel blocking agent may be increased Mental depression (history of)—Flunarizine may cause mental depression Parkinson's disease or similar problems—Flunarizine can cause parkinsonian-like effects Other heart or blood vessel disorders—Calcium channel blocking agents may make some heart conditions worse

Drug

Diltiazem HCL

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Not all of the side effects listed below have been reported for each of these medicines, but they have been reported for at least one of them. Since many of the effects of calcium channel blocking agents are similar, some of these side effects may occur with any of these Viagra To Purchases. However, they may be more common with some of these Viagra To Purchases than with others. Check with your doctor as soon as possible if any of the following side effects occur: Less common Breathing difficulty, coughing, or wheezing; irregular or fast, pounding heartbeat; skin rash ; slow heartbeat (less than 50 beats per minute—bepridil, diltiazem, and verapamil only); swelling of ankles, feet, or lower legs (more common with amlodipine, felodipine and nifedipine) For flunarizine only--less common Loss of balance control; mask-like face; mental depression; shuffling walk; stiffness of arms or legs; trembling and shaking of hands and fingers; trouble in speaking or swallowing Rare Bleeding, tender, or swollen gums; chest pain (may appear about 30 minutes after Viagra To Purchase is taken); fainting; painful, swollen joints (for nifedipine only); trouble in seeing (for nifedipine only) For flunarizine and verapamil only--rare Unusual secretion of milk Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to Viagra To Purchase. However, check with your doctor if any of the following side effects continue or are bothersome: More common Drowsiness (for flunarizine only); increased appetite and/or weight gain (for flunarizine only) Less common Constipation; diarrhea; dizziness or lightheadedness (more common with bepridil and nifedipine) ; dryness of mouth (for amlodipine and flunarizine only); flushing and feeling of warmth (more common with nicardipine and nifedipine); headache (more common with amlodipine, felodipine, isradipine, and nifedipine); nausea (more common with bepridil and nifedipine); unusual tiredness or weakness Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Precautions

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Notes

Amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, and verapamil belong to the group of medicines called calcium channel blocking agents. Calcium channel blocking agents affect the movement of calcium into the cells of the heart and blood vessels. As a result, they relax blood vessels and increase the supply of blood and oxygen to the heart while reducing its workload. Some of the calcium channel blocking agents are used to relieve and control angina pectoris (chest pain). Some are also used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled. Flunarizine is used to prevent migraine headaches. Nimodipine is used to prevent and treat problems caused by a burst blood vessel around the brain (also known as a ruptured aneurysm or subarachnoid hemorrhage). Other calcium channel blocking agents may also be used for these and other conditions as determined by your doctor. These medicines are available only with your doctor's prescription, in the following dosage forms: Oral Amlodipine Tablets (U.S. and Canada) Bepridil Tablets (U.S.) Diltiazem Extended-release capsules (U.S. and Canada) Tablets (U.S. and Canada) Felodipine Extended-release tablets (U.S. and Canada) Flunarizine Capsules (Canada) Isradipine Capsules (U.S.) Nicardipine Capsules (U.S.) Nifedipine Capsules (U.S. and Canada) Extended-release tablets (U.S. and Canada) Nimodipine Capsules (U.S. and Canada) Verapamil Extended-release capsules (U.S. and Canada) Tablets (U.S. and Canada) Extended-release tablets (U.S. and Canada) Parenteral Diltiazem Injection (U.S. and Canada) Verapamil Injection (U.S. and Canada)

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Missed Dose

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Monograph

Amlodipine, bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, and verapamil belong to the group of medicines called calcium channel blocking agents.

Other Uses

Once a Viagra To Purchase has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, calcium channel blocking agents are used in certain patients with the following medical conditions: Hypertrophic cardiomyopathy (a heart condition) (verapamil) Raynaud's phenomenon (circulation problems) (nicardipine and nifedipine) Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

How To Use

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with food or milk. For patients taking this Viagra To Purchase 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 Viagra To Purchase 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 Viagra To Purchase 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 Viagra To Purchases. 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 Viagra To Purchase. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the Viagra To Purchase 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):

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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.

Drug Interactions

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