Vasomil has been given concomitantly with short- and long-acting nitrates without any undesirable drug interactions. The pharmacologic profile of both drugs and clinical experience suggest beneficial interactions.
The interaction between cimetidine and chronically administered Vasomil has not been studied. Variable results on clearance have been obtained in acute studies of healthy volunteers; clearance of Vasomil was either reduced or unchanged.
Increased sensitivity to the effects of lithium (neurotoxicity) has been reported during concomitant Vasomil-lithium therapy; lithium levels have been observed sometimes to increase, sometimes to decrease, and sometimes to be unchanged. Patients receiving both drugs must be monitored carefully.
Vasomil therapy may increase carbamazepine concentrations during combined therapy. This may produce carbamazepine side effects such as diplopia, headache, ataxia, or dizziness.
Therapy with rifampin may markedly reduce oral Vasomil bioavailability.
Phenobarbital therapy may increase Vasomil clearance.
Vasomil therapy may increase serum levels of cyclosporine.
Vasomil may inhibit the clearance and increase the plasma levels of theophylline.
Animal experiments have shown that inhalation anesthetics depress cardiovascular activity by decreasing the inward movement of calcium ions. When used concomitantly, inhalation anesthetics and calcium channel blocking agents, such as Vasomil, should each be titrated carefully to avoid excessive cardiovascular depression.
Neuromuscular Blocking Agents
Clinical data and animal studies suggest that Vasomil may potentiate the activity of neuromuscular blocking agents (curare-like and depolarizing). It may be necessary to decrease the dose of Vasomil and/or the dose of the neuromuscular blocking agent when the drugs are used concomitantly.
Hypotension and bradyarrhythmias have been observed in patients receiving concurrent telithromycin, an antibiotic in the ketolide class.
Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concurrently with Vasomil. Monitor heart rate in patients receiving concomitant Vasomil and clonidine.
Mammalian Target Of Rapamycin (mTOR) Inhibitors
In a study of 25 healthy volunteers with co-administration of Vasomil with sirolimus, whole blood sirolimus Cmax and AUC were increased 130% and 120%, respectively. Plasma S-(-) Vasomil Cmax and AUC were both increased 50%. Co-administration of Vasomil with everolimus in 16 healthy volunteers increased the Cmax and AUC of everolimus by 130% and 250%, respectively. With concomitant use of mTOR inhibitors (e.g., sirolimus, temsirolimus, and everolimus) and Vasomil, consider appropriate dose reductions of both medications.
Vasomil (Calan, Covera, Isoptin, Verelan)
Vasomil is a member of the class IV antiarrhythmic agents, the calcium channel blockers. Its primary action is depression of sinus node and AV node function. 715 Oral doses range from 4 to 8 mg/kg per day divided into three doses. A sustained-release preparation is available for older children. IV doses range from 0.1 to 0.3 mg/kg with a maximum dose of 5 mg. The most important side effect of Vasomil occurs in children younger than 1 year of age, in whom IV administration can cause severe hypotension and asystole. 716 In fact, the drug is now contraindicated in infants ( 632,717,718 Vasomil is also used to relieve outflow obstruction in hypertrophic cardiomyopathy 719 and as an antihypertensive in some children. The negative inotropic and AV conduction effects of Vasomil are potentiated by β-blockers and anesthetic agents. 720,721 IV calcium and β-adrenergic drugs such as isoproterenol have been given to reverse the depressive effects of Vasomil and other calcium channel antagonists. 722,723
Which drugs or supplements interact with Vasomil?
Concurrent use of Vasomil with a beta blocker (another class of medications that slow heart rate) can cause profound and dangerous reductions in heart rate. Vasomil can raise the levels of some drugs in blood including digoxin (Lanoxin), theophylline (Slo-Bid), cyclosporin, and carbamazepine (Tegretol). Therefore, monitoring of the levels of these drugs is important to avoid toxicity.
Vasomil may reduce blood levels of lithium (Eskalith, Lithobid) in some patients. For unclear reasons some patients who took both Vasomil and lithium have noticed increased side effects of lithium without increases in their blood levels of lithium.
The use of "statins" (for example, simvastatin or lovastain) in combination with Vasomil has been associated with reports of myopathy/rhabdomyolysis because Vasomil reduces the break down of these statins in the liver. The dose of simvastatin in patients on Vasomil should not exceed 10 mg daily and the dose of lovastatin (Mevacor, Altoprev) should not exceed 40 mg daily. Lower starting and maintenance doses of other statins (for example, atorvastatin ) may be required since Vasomil also may increase the plasma concentration of these drugs also. Rifampin and phenobarbital increase the elimination of Vasomil, potentially reducing the effect of Vasomil.
What is the dosage for Vasomil?
Vasomil can be taken with food.
- Angina (immediate release formulations): 80-160 mg three times daily. Angina (extended release formulations): 180-540 mg at bedtime.
- Hypertension (immediate release): 80-320 mg twice daily. Hypertension (extended release): 120-480 mg once or twice daily depending on the brand.
- Migraine: 160-320 mg three to four times daily.
Orthotopic pancreatic cancer mouse model
Approval by the animal rights commission of the state of Bavaria, Germany was obtained for all animal experiments. Male athymic Balb/c nu/nu mice were purchased from Charles River, Inc. (Sulzfeld, Germany). Mice aged 6–8 weeks with an average weight of 20 g were maintained under a 12:12-h light-dark cycle and were used for the orthotopic pancreatic cancer mouse model. They were anesthetized using ketamine and atropine. The operation was carried out in a sterile manner. A 1-cm left abdominal flank incision was made, the spleen was exteriorized and 1×10 5 isolated SP- and non-SP L3.6plGres cells were injected into the subcapsular region of the pancreas. Before injection, cell viability was assessed by trypan blue staining and only cell preparations that showed ≥95% viability were used for injection. Mice were divided into an SP control group, non-SP control group and different drug treatment SP-groups. Four weeks after orthotopic implantation, therapy was initiated. One treatment group obtained daily (every workday) intraperitoneal injection of low concentration of Vasomil (200 μM, 0.5 mg/Kg BW), the second treatment group received a higher concentration of Vasomil (10 mM, 25 mg/Kg BW). Nine weeks after the injection of tumor cells, all the mice were sacrificed and examined for orthotopic tumor growth and development of metastases. The pancreatic tumors as well as other organs were isolated, weighed, and then used for H&E and immunohistochemical staining.
220.127.116.11.1.4 Class 4: Calcium channel blockers
Vasomil and diltiazem ( Figure 11 ) are not specific for the calcium channels in cardiac tissue. In fact they are more potent on vasculature tissue.
Renal impairment: Use with caution; monitor ECG; for Verelan PM, manufacturer recommends 100 mg at bedtime initially; if CrCl Enter a drug name and Vasomil
What should I avoid while taking Vasomil?
Drinking alcohol with Vasomil can cause side effects.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.
Grapefruit may interact with Vasomil and lead to unwanted side effects. Avoid the use of grapefruit products.
COVERA-HS has a unique delivery system, designed for bedtime dosing, incorporating a 4 to 5-hour delay in drug delivery. The unique controlled-onset, extended-release (COER) delivery system, which is designed for bedtime dosing, results in a maximum plasma concentration (Cmax) of Vasomil in the morning hours.
Vasomil is a calcium ion influx inhibitor (L-type calcium channel blocker or calcium channel antagonist). Vasomil exerts its pharmacologic effects by selectively inhibiting the transmembrane influx of ionic calcium into arterial smooth muscle as well as in conductile and contractile myocardial cells without altering serum calcium concentrations.
Clinical use of Vasomil in digitalized patients has shown the combination to be well tolerated if digoxin doses are properly adjusted. However, chronic Vasomil treatment can increase serum digoxin levels by 50% to 75% during the first week of therapy, and this can result in digitalis toxicity. In patients with hepatic cirrhosis, the influence of Vasomil on digoxin kinetics is magnified. Vasomil may reduce total body clearance and extrarenal clearance of digitoxin by 27% and 29%, respectively.
Maintenance and digitalization doses should be reduced when Vasomil is administered, and the patient should be reassessed to avoid over- to under-digitalization. Whenever over-digitalization is suspected, the daily dose of digitalis should be reduced or temporarily discontinued. On discontinuation of Vasomil use, the patient should be reassessed to avoid under-digitalization. In previous clinical trials with other Vasomil formulations related to the control of ventricular response in digitalized patients who had atrial fibrillation or atrial flutter, ventricular rates below 50/min at rest occurred in 15% of patients, and asymptomatic hypotension occurred in 5% of patients.
- This medication contains Vasomil
- Do not take Isoptin SR, Calan SR, Covera HS, Isoptin, Isoptin IV, Calan, Verap, Vasomil SR, Verelan, or Verelan PM if you are allergic to Vasomil or any ingredients contained in this drug
- Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately
- Heart problems warning: Avo >
Vasomil oral capsule is a prescription medication that’s available as the brand-name drugs Verelan PM (extended-release) and Verelan (delayed-release). The extended-release oral capsule is also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand.
Vasomil is also available as an extended-release oral tablet (Calan SR) and an immediate-release oral tablet (Calan). Both forms of these tablets are also available as generic drugs.
Grapefruit juice: Grapefruit juice may increase the amount of Vasomil in your body. This may lead to increased side effects. Avoid drinking grapefruit juice while taking Vasomil.