Calpresol
Generic Name
calpress
Manufacturer
MediPharm Co. Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Calpress is a novel dihydropyridine calcium channel blocker used for the treatment of hypertension (high blood pressure) and angina pectoris (chest pain). It helps relax blood vessels, allowing blood to flow more easily.
Uses & Indications
Dosage
Adults
Initial dose is 5 mg once daily. May be increased to a maximum of 10 mg once daily, if necessary, after 7-14 days. For angina, 5-10 mg once daily.
Elderly
A starting dose of 2.5 mg once daily is recommended. Dosage adjustments should be made with caution.
Renal_impairment
No dosage adjustment is typically required for patients with renal impairment due to extensive hepatic metabolism and excretion of inactive metabolites.
How to Take
Calpress tablets should be taken orally, with or without food, preferably at the same time each day to maintain consistent blood levels.
Mechanism of Action
Calpress inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle cells. This inhibition leads to systemic and coronary vasodilation, resulting in decreased peripheral vascular resistance, reduced blood pressure, and improved myocardial oxygen supply.
Pharmacokinetics
Onset
Onset of antihypertensive effect is gradual, usually within 6-12 hours after a single oral dose.
Excretion
Excreted primarily via the kidneys as inactive metabolites, with approximately 60% of the administered dose excreted in urine and 20-25% in feces.
Half life
Plasma elimination half-life is approximately 30-50 hours, allowing for once-daily dosing.
Absorption
Well absorbed after oral administration, with peak plasma concentrations occurring within 6-12 hours. Bioavailability is approximately 64-90%.
Metabolism
Extensively metabolized in the liver (primarily via CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to calpress or other dihydropyridine calcium channel blockers
- Cardiogenic shock
- Severe aortic stenosis
- Unstable angina or myocardial infarction within the last 28 days
Drug Interactions
Beta-blockers
Concurrent use may lead to additive hypotensive and negative inotropic effects, especially in patients with impaired ventricular function. Monitor cardiovascular status.
Grapefruit juice
May increase the bioavailability of calpress, enhancing its hypotensive effects. Avoid concurrent use.
CYP3A4 inducers (e.g., Rifampicin, Carbamazepine, Phenytoin)
May decrease plasma concentrations of calpress, potentially reducing its effectiveness. Monitor blood pressure closely.
CYP3A4 inhibitors (e.g., Ketoconazole, Itraconazole, Ritonavir)
May increase plasma concentrations of calpress, leading to an increased risk of hypotension and edema. Dose adjustment may be necessary.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Overdose of calpress can result in excessive peripheral vasodilation with marked hypotension and possibly reflex tachycardia. Severe, prolonged systemic hypotension may result in shock and death. Management involves active cardiovascular support, including monitoring cardiac and respiratory function, elevation of extremities, and management of circulating fluid volume. Intravenous calcium gluconate may be beneficial to reverse the effects of calcium channel blockade.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether calpress is excreted in human milk; caution should be exercised when administered to a nursing mother. Consult your doctor.
Side Effects
Contraindications
- Known hypersensitivity to calpress or other dihydropyridine calcium channel blockers
- Cardiogenic shock
- Severe aortic stenosis
- Unstable angina or myocardial infarction within the last 28 days
Drug Interactions
Beta-blockers
Concurrent use may lead to additive hypotensive and negative inotropic effects, especially in patients with impaired ventricular function. Monitor cardiovascular status.
Grapefruit juice
May increase the bioavailability of calpress, enhancing its hypotensive effects. Avoid concurrent use.
CYP3A4 inducers (e.g., Rifampicin, Carbamazepine, Phenytoin)
May decrease plasma concentrations of calpress, potentially reducing its effectiveness. Monitor blood pressure closely.
CYP3A4 inhibitors (e.g., Ketoconazole, Itraconazole, Ritonavir)
May increase plasma concentrations of calpress, leading to an increased risk of hypotension and edema. Dose adjustment may be necessary.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Overdose of calpress can result in excessive peripheral vasodilation with marked hypotension and possibly reflex tachycardia. Severe, prolonged systemic hypotension may result in shock and death. Management involves active cardiovascular support, including monitoring cardiac and respiratory function, elevation of extremities, and management of circulating fluid volume. Intravenous calcium gluconate may be beneficial to reverse the effects of calcium channel blockade.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether calpress is excreted in human milk; caution should be exercised when administered to a nursing mother. Consult your doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture when stored under recommended conditions.
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by regulatory authorities
Patent Status
Patented
WHO Essential Medicine
YesClinical Trials
Currently, phase IV clinical trials are ongoing to evaluate the long-term cardiovascular outcomes of calpress in high-risk populations. Several studies have confirmed its efficacy and safety in initial trials across diverse patient groups.
Lab Monitoring
- Regular blood pressure monitoring
- Heart rate monitoring
- Liver function tests (periodically, especially in patients with hepatic impairment)
Doctor Notes
- Advise patients on comprehensive lifestyle modifications for hypertension management including diet, exercise, and stress reduction.
- Monitor blood pressure and heart rate regularly at follow-up visits.
- Educate patients about the common side effect of peripheral edema and when to report it.
- Consider dose adjustment in elderly patients, those with hepatic impairment, or patients concurrently taking strong CYP3A4 inhibitors.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor and do not change the dose without consultation.
- Do not stop taking calpress suddenly without consulting your doctor, as this may worsen your condition.
- Report any unusual swelling, severe headache, or chest pain to your doctor immediately.
- Store the medicine as directed.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Calpress may cause dizziness, especially at the start of treatment or when changing doses. Patients should be cautioned about operating machinery or driving until they know how calpress affects them and are sure it is safe.
Lifestyle Advice
- Maintain a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and excessive alcohol consumption.
- Manage stress effectively through relaxation techniques or hobbies.
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