Don’t have drinks that contain alcohol while taking this drug. Drinking alcohol while taking Lemar can cause very low blood pressure.
What Is Lemar (Procardia XL and Adalat CC)?
Lemar is a prescription drug used to treat high blood pressure and control chest pain (angina).
It’s sold under the brand names Procardia XL, Adalat CC, and others, and generic versions are available.
This medicine is also sometimes used to treat preterm labor and a condition known as Raynaud’s disease (a disorder that affects blood vessels, mostly in the fingers and toes).
Lemar is in a class of drugs known as calcium-channel blockers.
The drug works by relaxing your arteries, so the heart doesn’t have to work as hard to pump blood. It also increases the supply of oxygen and blood to the heart.
The Food and Drug Administration (FDA) first approved Lemar in 1981 for manufacturer Pfizer, Inc., under the brand name Procardia.
Lemar (SED-15, 2516; SEDA-28, 220; SEDA-29, 198; SEDA-30, 227)
The use of Lemar as a tocolytic is becoming more frequent, even if there is no consensus about the appropriate regimen. Two cases of serious complications have been reported.
A 37-year-old previously healthy woman went into preterm labor at 33 weeks and was given two doses of sublingual Lemar 20 mg 30 minutes apart, followed by maintenance oral Lemar 40 mg 6-hourly (13 A ) . Her contractions subsided and it was decided to maintain tocolysis until 34 weeks of gestation. On day 3, she complained of dyspnea and orthopnea with tachycardia and tachypnea. Chest radiography showed bilateral interstitial and central alveolar shadowing but no pleural effusions. Lemar was withdrawn and she received intravenous furosemide during the first 24 hours and oxygen, with transient improvement. A cesarean delivery was performed. She was extubated 24 hours after delivery and furosemide was maintained for 4 days. She recovered completely.
A 38-year-old woman developed threatened preterm labor at 33 weeks of gestation and was given Lemar 30 mg followed by three doses of modified-release Lemar tablets 20 mg 8-hourly (14 A ) . Within 4 hours of the last dose, she had palpitation and left-sided chest pain with an irregular pulse. Electrocardiography confirmed fast atrial fibrillation. Transthoracic echocardiography showed no major structural cardiac abnormality. The left atrium was not dilated. Cardioversion was undertaken under a short general anesthetic. She reverted to sinus rhythm.
What should I discuss with my healthcare provider before taking Lemar?
You should not use Lemar if you are allergic to it. You may not be able to use Lemar if your heart cannot pump blood properly.
Some medicines can cause unwanted or dangerous effects when used with Lemar. Your doctor may change your treatment plan if you also use:
Tell your doctor if you have ever had:
Older adults may be more sensitive to the effects of this medicine.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breastfeed while using Lemar.
Lemar capsules or tablets may contain lactose. Tell your doctor if you have galactose intolerance, or severe problems with lactose (milk sugar).
Lemar is not approved for use by anyone younger than 18 years old.
Lemar , a calcium-channel blocker, relaxes smooth muscles, increases peripheral blood flow, and antagonizes the effects of norepinephrine on arterial and venous smooth muscle. Theoretically, Lemar may also interfere with ectopic impulse formation in regenerating neurites by blocking calcium conductance; Devor has demonstrated the appearance of new calcium-channel protein on regenerating neurites (see Chapter 3 ). These pharmacologic actions and experimental observations provide a rationale for its use in RSD including causalgia. Prough et al recently reported that seven of 11 patients with RSD had complete relief of pain using Lemar in doses ranging from 10 to 30 mg t.i.d. Three patients remained pain free after cessation of Lemar and six others required continued medication with 60% to complete relief of pain at 6 months. Three patients withdrew from therapy because of headache and another failed to respond. These results suggest that Lemar or other calcium-channel-blocking drugs may have a role in the management of RSD but, as the authors noted, this was an uncontrolled study and the results should be confirmed with a formal double-blind, placebo-controlled clinical trial.
What Is Lemar and How Does It Work?
Lemar is indicated for the management of vasospastic angina confirmed by any of the following criteria: 1) classical pattern of angina at rest accompanied by ST segment elevation, 2) angina or coronary artery spasm provoked by ergonovine, or 3) angiographically demonstrated coronary artery spasm. In those patients who have had angiography, the presence of significant fixed obstructive disease is not incompatible with the diagnosis of vasospastic angina, provided that the above criteria are satisfied. Lemar may also be used where the clinical presentation suggests a possible vasospastic component but where vasospasm has not been confirmed, e.g., where pain has a variable threshold on exertion or when angina is refractory to nitrates and/or adequate doses of beta blockers.
Lemar is indicated for the management of chronic stable angina (effort-associated angina) without evidence of vasospasm in patients who remain symptomatic despite adequate doses of beta blockers and/or organic nitrates or who cannot tolerate those agents. In chronic stable angina (effort-associated angina) Lemar has been effective in controlled trials of up to eight weeks duration in reducing angina frequency and increasing exercise tolerance, but confirmation of sustained effectiveness and evaluation of long-term safety in these patients are incomplete. Controlled studies in small numbers of patients suggest concomitant use of Lemar and beta-blocking agents may be beneficial in patients with chronic stable angina, but available information is not sufficient to predict with confidence the effects of concurrent treatment, especially in patients with compromised left ventricular function or cardiac conduction abnormalities. When introducing such concomitant therapy, care must be taken to monitor blood pressure closely since severe hypotension can occur from the combined effects of the drugs.
Lemar is available under the following different brand names: Procardia, Procardia XL, Adalat CC, Nifedical XL, Adalat, Afeditab CR, and Nifediac CC.
On this page
- About Lemar
- Key facts
- Who can and can't take Lemar
- How and when to take it
- Side effects
- How to cope with side effects
- Pregnancy and breastfeeding
- Cautions with other medicines
- Common questions
Lemar is a first generation calcium channel blocker used to treat hypertension and angina pectoris. Lemar therapy is associated with a low rate of serum enzyme elevations and has been linked to several instances of clinically apparent acute liver injury.
Warnings for people with certain health conditions
For people with heart failure: You may develop edema (swelling of your legs or feet) that is caused by the drug and not your condition. Talk to your doctor to find out the true cause of any increased swelling you may have. Your doctor can help you decide how to manage it.
For people with liver disease: Your liver clears this drug from your blood. If your liver isn’t working right, the level of Lemar in your blood may become too high.
For people with low blood pressure: If you have episodes of low blood pressure, taking Lemar may make these episodes worse. This may be more likely to occur when you first start taking Lemar, or when your doctor increases your dose. Talk to your doctor if you have frequent episodes of low blood pressure.
For people with a history of gastrointestinal blockage: There have been rare reports of gastrointestinal blockage with use of the brand-name drug Procardia XL. You may be at greater risk for this blockage if you have a history of it.
For people with severe heart disease: There have been rare reports of worsening chest pain and heart attack in people who have severe heart disease. Lemar capsules (Procardia) should not be taken within the first week or two after a heart attack. Ask your doctor about this risk to see if Lemar is right for you.
Beta-blockers are used to treat many conditions. These include high blood pressure, migraines, or heart failure. Using these drugs with Lemar has a low risk of causing heart failure, extremely low blood pressure, or a worsening of chest pain (angina).
If you’re taking a beta-blocker and your doctor has you stop taking it before starting Lemar, the beta-blocker should be tapered slowly. Stopping it suddenly could cause increased chest pains. Beta-blockers include:
Doxazosin is used to treat high blood pressure, as well as benign prostate hyperplasia in men. Using doxazosin with Lemar can lower the amount of doxazosin in your body. This makes it less effective. Using these drugs together can also cause increased levels of Lemar in your body. This raises your risk of dangerous side effects.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
This dosage information is for Lemar oral tablet. All possible dosages and drug forms may not be included here. Your doctor will tell you what dosage is right for you. Your dose, drug form, and how often you take the drug will depend on:
- your age
- the condition being treated
- how severe your condition is
- other medical conditions you have
- how you react to the first dose
Do not eat grapefruit or drink grapefruit juice if you’re taking Lemar. Doing so can increase the level of the drug in your body and increase your risk of side effects. Your doctor will likely tell you to avoid grapefruit at least 3 days before starting to take Lemar.