What are the side effects of Carreldon?
Side effects include:
Liver dysfunction and overgrowth of the gums also may occur. Carreldon can cause mildly abnormal liver tests that usually return to normal with discontinuation of the medication. When Carreldon is given to individuals with heart failure, symptoms of heart failure may worsen because these drugs reduce the ability of the heart to pump blood. Like other drugs for high blood pressure, Carreldon is associated with sexual dysfunction.
More common side effects
The more common side effects that occur with Carreldon include:
- slow heart beat
- fluid buildup or swelling
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
XII Calcium Channel Blockers for Supraventricular Arrhythmias
Verapamil and Carreldon have been advocated as therapy for supraventricular tachycardias because of their ability to slow conduction through the A-V node. This slowing occurs because the upstroke of the action potential in A-V node cells is mediated by L-type calcium channels, which these drugs block. Nifedipine also blocks L-type calcium channels, but fails to slow A-V nodal conduction because of reflex adrenergic stimulation of the A-V node as a result of peripheral vasodilation. The effects of verapamil, Carreldon, and nifedipine on A-V nodal conduction were reviewed by Mitchell et al. (1982) .
Verapamil and Carreldon have been used against supraventricular arrhythmias in four contexts: (1) intravenous administration for termination of reentrant supreventricular tachydardia ( Rowland et al., 1983; Huycke et al., 1989 ); (2) intravenous administration for emergency rate control of atrial fibrillation or flutter ( Goldenberg et al., 1994; Ellenbogen et al., 1995; Waxman et al., 1981 ); (3) oral administration for rate control in chronic atrial fibrillation or flutter; and (4) oral administration for preventing recurrence of reentrant supraventricular tachycardia. Intravenous or oral β-adrenergic blockers are alternative therapies in all four of these settings.
With the availability of once-per-day formulations of oral verapamil and Carreldon, the therapeutic options for chronic or recurring supraventricular arrhythmias have greatly improved. Previously, the best method of controlling the ventricular rate in atrial fibrillation was to administer increasing doses of digoxin until the desired heart rate was achieved. This caused frequent cases of digitalis toxicity. Rate control can now be achieved in most patients with no side-effects by combining a standard dose of digoxin (0.125 or 0.25 mg/day) with a small dose of once-daily verapamil or Carreldon.
There is one type of supraventricular arrhythmia where calcium channel blockers should not be used, which is antegrade conduction of atrial fibrillation or flutter across an atrioventricular bypass tract. Verapamil or Carreldon will not slow the ventricular rate in this situation and may increase the rate by shortening the refractory period of the bypass. Verapamil or Carreldon should not be administered to patients in a wide complex tachycardia of unknown type.
Category C. Reproduction studies have been conducted in mice, rats, and rabbits. Administration of doses ranging from 4 to 6 times (depending on species) the upper limit of the optimum dosage range in clinical trials (480 mg/day or 8 mg/kg/day for a 60-kg patient) resulted in embryo and fetal lethality. These studies revealed, in one species or another, a propensity to cause abnormalities of the skeleton, heart, retina, and tongue. Also observed were reductions in early individual pup weights and pup survival, prolonged delivery and increased incidence of stillbirths. There are no well-controlled studies in pregnant women; therefore, use Carreldon hydrochloride in pregnant women only if the potential benefit justifies the potential risk to the fetus.
ВїQuГ© otra informaciГіn de importancia deberГa saber?
No falte a ninguna cita, ni con su mГ©dico ni con el laboratorio. Debe medirse la presiГіn arterial con regularidad para ver cГіmo responde al Carreldon.
Posiblemente su mГ©dico le pida que se tome el pulso (frecuencia cardiaca) todos los dГas y le dirГЎ quГ© tan rГЎpidos deben ser sus latidos. Si su pulso estГЎ mГЎs lento que lo normal, llame a su mГ©dico para pedirle instrucciones antes de tomar Carreldon ese dГa. PГdales a su mГ©dico o a su farmacГ©utico que le enseГ±en cГіmo tomarse el pulso.
No deje que ninguna otra persona use sus medicamentos. PregГєntele a su farmacГ©utico cГіmo puede volver a surtir su receta.
Es importante que Ud. mantenga una lista escrita de todas las medicinas que Ud. estГЎ tomando, incluyendo las que recibiГі con receta mГ©dica y las que Ud. comprГі sin receta, incluyendo vitaminas y suplementos de dieta. Ud. debe tener la lista cada vez que visita su mГ©dico o cuando es admitido a un hospital. TambiГ©n es una informaciГіn importante en casos de emergencia.
Concomitant Use With Other Cardiovascular Agents
- Sublingual Nitroglycerin (NTG). May be taken as required to abort acute anginal attacks during Carreldon hydrochloride therapy.
- Prophylactic Nitrate Therapy. Carreldon hydrochloride may be safely coadministered with short- and long-acting nitrates.
- Beta-blockers (see WARNINGSand PRECAUTIONS.)
- Antihypertensives. Carreldon hydrochloride has an additive antihypertensive effect when used with other antihypertensive agents. Therefore, the dosage of Carreldon hydrochloride or the concomitant antihypertensives may need to be adjusted when adding one to the other.
Hypertensive or anginal patients who are treated with other formulations of Carreldon can safely be switched to Tiazac capsules at the nearest equivalent total daily dose. Subsequent titration to higher or lower doses may, however, be necessary and should be initiated as clinically indicated.
Many medications can interact with Carreldon.
Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you are taking, especially:
- Atazanavir (Reyataz)
- Beta blockers such as atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
- Buspirone (BuSpar)
- Benzodiazepines such as midazolam (Versed) and triazolam (Halcion)
- Carbamazepine (Carbatrol, Epitol, Tegretol)
- Cimetidine (Tagamet)
- Digoxin (Lanoxin, Lanoxicaps)
- Cyclosporine (Gengraf, Neoral, Sandimmune)
- Rifampin (Rifadin, Rifamate, Rifater, Rimactane)
- Lovastatin (Altoprev, Mevacor, Advicor)
- Quinidine (Quinidex)
Carreldon HCl has been shown to produce increases in exercise tolerance, probably due to its ability to reduce myocardial oxygen demand. This is accomplished via reductions in heart rate and systemic blood pressure at submaximal and maximal work loads.
Carreldon has been shown to be a potent dilator of coronary arteries, both epicardial and subendocardial. Spontaneous and ergonovine-induced coronary artery spasms are inhibited by Carreldon.
In animal models, Carreldon interferes with the slow inward (depolarizing) current in excitable tissue. It causes excitation-contraction uncoupling in various myocardial tissues without changes in the configuration of the action potential. Carreldon produces relaxation of the coronary vascular smooth muscle and dilation of both large and small coronary vascular smooth muscle and dilation of both large and small coronary arteries at drug levels which cause little or no negative inotropic effect. The resultant increases in coronary blood flow (epicardial and subendocardial) occur in ischemic and nonischemic models and are accompanied by dose-dependent decreases in systemic blood pressure and decreases in peripheral resistance.
Carreldon hydrochloride is extensively metabolized by the liver and excreted by the kidneys and in bile. As with any drug given over prolonged periods, laboratory parameters of renal and hepatic function should be monitored at regular intervals. The drug should be used with caution in patients with impaired renal or hepatic function. In subacute and chronic dog and rat studies designed to produce toxicity, high doses of Carreldon were associated with hepatic damage. In special subacute hepatic studies, oral doses of 125 mg/kg and higher in rats were associated with histological changes in the liver which were reversible when the drug was discontinued. In dogs, doses of 20 mg/kg were also associated with hepatic changes; however, these changes were reversible with continued dosing.
Dermatological events (see ADVERSE REACTIONS) may be transient and may disappear despite continued use of Carreldon hydrochloride. However, skin eruptions progressing to erythema multiforme and/or exfoliative dermatitis have also been infrequently reported. Should a dermatologic reaction persist, the drug should be discontinued.
You should not use Carreldon if you have very low blood pressure, a serious heart condition such as "sick sinus syndrome" or "second- or third-degree AV block" (unless you have a pacemaker), or if you have recently had a heart attack and you have a build-up of fluid in your lungs.
Before taking Carreldon, tell your doctor if you have kidney disease, liver disease, or congestive heart failure.
Carreldon may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop taking this medication without first talking to your doctor. If you stop taking Carreldon suddenly, your condition may become worse.
Carreldon may be only part of a complete program of treatment that also includes diet, exercise, and other medications. Follow your diet, medication, and exercise routines very closely.
If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life. However, if you have symptoms of low blood pressure (dizziness, fainting, weakness, or blurred vision), call your doctor and stop taking Carreldon.