Calcium channel blockers

Generic name	Brand name
___ amlodipine	Norvasc®
___ diltiazem	Cardizem® Dilacore® Tiazac®
___ isradipine	DynaCirc®
___ nicardipine	Cardene®
___ nifedipine	Adalat®, Procardia®
___ nimlodipine	Nimodipine®
___ verapamil	Calan®, Covera HS®, Isoptin®, Verelan®

How do these medicines work?

Calcium channel blockers are used to treat many conditions, including high blood pressure (hypertension) and some heart conditions. They affect the movement of calcium into the cells of the heart and blood vessels. As a result, they relax blood vessels and reduce the heart's workload. They also slow the heart rate.

How should I give it?

Most of these medicines come in pill form. Some are available in liquid form and injection form.

Give it at regular times to keep a steady level in the bloodstream. If your child is taking more than one dose daily, the last dose may be given at bedtime to avoid tiredness during the day.

Give this medicine exactly as prescribed, even if your child feels fine.

Your child should be awake and alert when taking any medicine. Follow these instructions:

___ If using the liquid form, shake well right before using. Draw up the correct amount in the medicine dropper or oral syringe. Give a small squirt of the medicine inside the cheek. To avoid choking, let your child swallow each squirt before giving more.

___ For babies, you may want to mix the medicine with a small amount of formula or breast milk and give it with a bottle nipple before feeding. Do not add the medicine to a whole bottle because if your baby does not finish it, you will not know how much of the medicine was taken.

Other instructions:

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Note: if your child's medicine is a long-acting product (noted by CR, XR, XT, XL, CD, or SR after the name), it should not be crushed, chewed, or cut.

Are there any precautions about food or other medicines?

Follow your doctor's directions for using this medicine. It is best if this medicine is taken on an empty stomach. However, you may give it with food if it upsets your child's stomach.

Avoid alcohol-containing foods, beverages, or non-prescription medicines (such as cough syrup) while taking this medicine. Do not take this medicine with grapefruit juice.

Warning! Certain medicines interact with calcium channel blockers. It is very important to check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

What should I do if a dose is missed?

If a dose is missed, and it is prescribed once daily, take the missed dose as soon as you remember that day. For medicines that are prescribed more often, follow these guidelines:

If it is prescribed:	Give it no closer than:
twice daily	6 hours from the next dose
3 times daily	3 hours from the next dose
4 times daily	skip the missed dose

If it is too close to the next dose, skip the missed dose and continue with the regular schedule. Never give a double dose.

If your child vomits (throws up) within 30 minutes after receiving a dose, give it again. If your child vomits the second dose, do not repeat it again. If your child misses or vomits two doses, please call the clinic.

What are the side effects?

Common

low blood pressure
sleepiness
lightheadedness, dizziness
tiredness, weakness
nausea

Occasional

headache
constipation
confusion
depression
swelling in the legs, ankles or feet
abdominal (belly) pain

Rare

nightmares
muscle cramps
rash
change in sense of taste

The person taking this medicine should not drive, operate machinery, or do anything else that could be dangerous (such as bicycling or riding a lawn mower) until it is clear that no risky side effects are present.

The dose may need to be increased slowly, to avoid side effects.

This medicine may make your child's skin more sensitive to the sun. Use sunscreen and avoid sunlamps and tanning beds.

If your child has other side effects that you think are due to this medicine, call your doctor or pharmacist.

When should I call the clinic?

slow, fast or irregular heartbeat, or chest pain that lasts longer than 15 minutes
fainting or going unconscious (unaware of what is going on)
swelling of the legs, ankles, or feet
allergic reaction; signs include:
- fever or chills
- rash or hives
- wheezing
- trouble breathing - call 911

What else do I need to know?

Inform your doctor immediately if your child has any of the following:

heart problems
asthma or other breathing difficulties
diabetes
thyroid conditions

Your doctor may ask your child to come to the clinic for examination to find out if the dose or the medicine needs to be changed.

You and your child should know the names of all the medicines he or she is taking. Share this information with anyone involved in your child's care. Please remember to bring the medicine container when your child comes to the clinic or emergency department.

Do not stop giving the medicine abruptly.

Always make sure you have enough medicine on hand. Each time you refill your prescription, check to see how many refills are left. If no refills are left, the pharmacy will need 2 or 3 days to contact the doctor to renew the prescription.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines. If there is no "take-back" program empty them into the trash.

Store all medicines in their original container and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children's reach, locked up if possible.

If too much or the wrong kind of medicine is taken, call the Poison Control Center toll-free at 1-800-222-1222. If your child is unconscious or has a seizure, call 911.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call the clinic or pharmacy.

This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit www.childrensmn.org/educationmaterials.