{"id":61139,"date":"2024-02-28T07:26:43","date_gmt":"2024-02-28T07:26:43","guid":{"rendered":"https:\/\/medsname.com\/calaptin-40\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"calaptin-40","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/calaptin-40\/","title":{"rendered":"Calaptin 40"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">&#9889; Quick Answer &mdash; What is Calaptin 40?<\/h3>\n<p style=\"margin:0;\"><strong>Calaptin 40<\/strong> je <strong>40 mg IR verapamil immediate-release tablet<\/strong> from Piramal &mdash; a phenylalkylamine non-dihydropyridine CCB. Unlike dihydropyridines (amlodipine, nifedipine) which act almost purely on arterial smooth muscle, verapamil has <strong>Strong cardiac depressant<\/strong> &mdash; substantial slowing of AV nodal conduction, significant reduction in heart rate, and notable negative inotropy (reduced cardiac contractility). More cardiac effect than diltiazem, less peripheral vasodilation. This profile makes it useful for <strong>hypertenzi kombinovanou s kontrolou srde\u010dn\u00ed frekvence<\/strong> (atrial fibrillation, chronic angina, PSVT). Plasma half-life IR 3-7 hours (TDS); SR\/ER 10-12 hours effective (once or twice daily). Typical hypertension dose: <strong>IR 40-80 mg three times daily; SR 120-180 mg once daily<\/strong>, target IR 80-120 mg TDS (240-480 mg\/day); SR 240-480 mg once or twice daily. <strong>Do NOT combine verapamil with a beta-blocker<\/strong> \u2014 riziko aditivn\u00ed bradykardie a srde\u010dn\u00edho bloku. Kontraindikov\u00e1no u srde\u010dn\u00edho selh\u00e1n\u00ed se sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed (HF-REF), AV bloku druh\u00e9ho\/t\u0159et\u00edho stupn\u011b, t\u011b\u017ek\u00e9 bradykardie, kardiogenn\u00edho \u0161oku a syndromu nemocn\u00e9ho sinu bez kardiostimul\u00e1toru.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">What Is Calaptin 40?<\/h2>\n<p>Calaptin 40 is an oral 40 mg IR verapamil tablet from Piramal, supplied in 30-180 tablets. Introduced 1967 (Knoll as <strong>Isoptin<\/strong>) &mdash; the oldest CCB in use, and the one with the <strong>strongest cardiac effect<\/strong>.<\/p>\n<p>Verapamil belongs to the <strong>nedihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f<\/strong> podt\u0159\u00edda, odli\u0161n\u00e1 od dihydropyridin\u016f (amlodipin, nifedipin) sv\u00fdmi <strong>p\u0159\u00edm\u00fdmi srde\u010dn\u00edmi \u00fa\u010dinky<\/strong> \u2014 zpomalen\u00edm AV nod\u00e1ln\u00edho veden\u00ed, sn\u00ed\u017een\u00edm srde\u010dn\u00ed frekvence a (v\u00edce u verapamilu ne\u017e u diltiazemu) sn\u00ed\u017een\u00edm srde\u010dn\u00ed kontraktility. Tento profil \u010din\u00ed ne-DHP u\u017eite\u010dn\u00e9, kdy\u017e hypertenze koexistuje se stavy vy\u017eaduj\u00edc\u00edmi kontrolu frekvence (fibrilace s\u00edn\u00ed, supraventrikul\u00e1rn\u00ed tachykardie, chronick\u00e1 angina pectoris).<\/p>\n<h2 class=\"wp-block-heading\">How Verapamil Works<\/h2>\n<p>Verapamil blocks L-type voltage-gated calcium channels in BOTH vascular smooth muscle AND cardiac muscle + conduction tissue (unlike DHPs, which are vascular-selective). This produces:<\/p>\n<ul>\n<li><strong>Arteri\u00e1ln\u00ed vazodilataci<\/strong> \u2014 sn\u00ed\u017een\u00fd syst\u00e9mov\u00fd c\u00e9vn\u00ed odpor, ni\u017e\u0161\u00ed krevn\u00ed tlak<\/li>\n<li><strong>Sn\u00ed\u017eenou rychlost veden\u00ed AV uzlem<\/strong> \u2014 pomalej\u0161\u00ed komorovou frekvenci p\u0159i fibrilaci s\u00edn\u00ed\/flutteru; ukon\u010den\u00ed reentry SVT<\/li>\n<li><strong>Negativn\u00ed chronotropii<\/strong> \u2014 pomalej\u0161\u00ed sinusov\u00fd rytmus<\/li>\n<li><strong>Negativn\u00ed inotropii<\/strong> \u2014 sn\u00ed\u017eenou srde\u010dn\u00ed kontraktilitu (v\u00fdznamnou u verapamilu, m\u00edrnou u diltiazemu)<\/li>\n<li><strong>Sn\u00ed\u017eenou spot\u0159ebu kysl\u00edku myokardem<\/strong> \u2014 antiangin\u00f3zn\u00ed \u00fa\u010dinek<\/li>\n<li><strong>Uvoln\u011bn\u00ed koron\u00e1rn\u00edho vasospasmu<\/strong> \u2014 prvn\u00ed volba u Prinzmetalovy\/variantn\u00ed anginy<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Hypertenze<\/strong><\/li>\n<li><strong>Paroxysmal supraventricular tachycardia (PSVT)<\/strong> &mdash; acute termination via IV; chronic oral prophylaxis<\/li>\n<li><strong>Kontrola frekvence p\u0159i fibrilaci s\u00edn\u00ed\/flutteru<\/strong> &mdash; when beta-blockers are contraindicated<\/li>\n<li><strong>Chronick\u00e1 stabiln\u00ed angina<\/strong><\/li>\n<li><strong>Cluster headache prophylaxis<\/strong> &mdash; one of the few effective options; typically 240-480 mg\/day SR<\/li>\n<li><strong>Hypertrophic obstructive cardiomyopathy<\/strong> (reduces outflow gradient by negative inotropy)<\/li>\n<li><strong>Profylaxe migr\u00e9ny<\/strong> &mdash; occasional use when calcium-channel-blocker preventive is preferred and <a href=\"https:\/\/medsbase.com\/cs\/sibelium\/\">flunarizin<\/a> is not available<\/li>\n<\/ul>\n<p><strong>Verapamil has the strongest negative inotropic and AV-blocking effect of the CCBs. NEVER combine with a beta-blocker outside of a specialist cardiology setting. Contraindicated in heart failure with reduced ejection fraction (HF-REF) &mdash; can precipitate decompensation.<\/strong><\/p>\n<h2 class=\"wp-block-heading\">Calaptin 40 Dosage<\/h2>\n<p><strong>Hypertenze:<\/strong><\/p>\n<ul>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka:<\/strong> IR 40-80 mg three times daily; SR 120-180 mg once daily<\/li>\n<li><strong>C\u00edlov\u00e1 d\u00e1vka:<\/strong> IR 80-120 mg TDS (240-480 mg\/day); SR 240-480 mg once or twice daily<\/li>\n<li>Titrujte ka\u017ed\u00fdch 1-2 t\u00fddny<\/li>\n<\/ul>\n<p><strong>Pod\u00e1v\u00e1n\u00ed:<\/strong> s j\u00eddlem nebo bez j\u00eddla. Polykejte cel\u00e9 \u2014 NEROZDRT\u011aTE a nerozd\u011blujte tablety s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (SR\/CD\/XL).<\/p>\n<p><strong>Monitorov\u00e1n\u00ed:<\/strong><\/p>\n<ul>\n<li>M\u011b\u0159it puls a TK na za\u010d\u00e1tku, po 2 t\u00fddnech, 4 t\u00fddnech a n\u00e1sledn\u011b pravideln\u011b<\/li>\n<li>Sledovat bradykardii (&lt;50 tep\u016f\/min = sn\u00ed\u017een\u00ed d\u00e1vky)<\/li>\n<li>EKG na za\u010d\u00e1tku a p\u0159i jak\u00e9koli symptomatick\u00e9 zm\u011bn\u011b (zv\u00e1\u017eit prodlou\u017een\u00ed PR intervalu \/ AV blok)<\/li>\n<li>V\u00fdchoz\u00ed a pravideln\u00e9 jatern\u00ed testy (jatern\u00ed metabolismus)<\/li>\n<li>U pacient\u016f u\u017e\u00edvaj\u00edc\u00edch digoxin: kontrolovat hladinu digoxinu (oba ne-DHP zvy\u0161uj\u00ed hladinu digoxinu ~70%)<\/li>\n<\/ul>\n<p><strong>Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> Postupn\u00e9 vysazov\u00e1n\u00ed b\u011bhem 1-2 t\u00fddn\u016f u vysok\u00fdch d\u00e1vek chronick\u00e9 terapie \u2014 n\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee zp\u016fsobit rebound anginu u pacient\u016f s ICHS.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Bradykardie<\/strong> (tep &lt;50\/min) \u2014 z\u00e1visl\u00e9 na d\u00e1vce; hlavn\u00ed d\u016fvod pro sn\u00ed\u017een\u00ed d\u00e1vky<\/li>\n<li><strong>Z\u00e1cpa<\/strong> \u2014 zejm\u00e9na verapamil (a\u017e u 40 % u\u017eivatel\u016f); m\u00e9n\u011b \u010dast\u00e9 u diltiazemu<\/li>\n<li>Z\u00e1vrat\u011b, \u00fanava<\/li>\n<li>Bolest hlavy (m\u00e9n\u011b ne\u017e u DHP)<\/li>\n<li>N\u00e1valy horka (m\u00e9n\u011b ne\u017e u DHP)<\/li>\n<li>Perifern\u00ed ed\u00e9m (m\u00e9n\u011b ne\u017e u DHP; st\u00e1le mo\u017en\u00e9)<\/li>\n<li>Nevolnost, b\u0159i\u0161n\u00ed dyskomfort<\/li>\n<\/ul>\n<p><strong>V\u00e1\u017en\u00e9, ale m\u00e9n\u011b \u010dast\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Srde\u010dn\u00ed blok<\/strong> (prodlou\u017een\u00ed PR intervalu, AV blok 1.\u20133. stupn\u011b) \u2014 zejm\u00e9na v kombinaci s betablok\u00e1tory, digoxinem nebo p\u0159i preexistuj\u00edc\u00edm poruch\u00e1ch veden\u00ed<\/li>\n<li><strong>Zhor\u0161en\u00ed srde\u010dn\u00edho selh\u00e1n\u00ed<\/strong> \u2014 ne-DHP jsou kontraindikov\u00e1ny u HF-REF kv\u016fli negativn\u00edmu inotropn\u00edmu \u00fa\u010dinku<\/li>\n<li>Hyperplazie d\u00e1sn\u00ed (dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed; m\u00e9n\u011b \u010dast\u00e9 ne\u017e u nifedipinu)<\/li>\n<li>Zv\u00fd\u0161en\u00ed jatern\u00edch enzym\u016f (obvykle m\u00edrn\u00e9, reverzibiln\u00ed)<\/li>\n<li>Erektiln\u00ed dysfunkce (\u010dast\u011bj\u0161\u00ed s verapamilem)<\/li>\n<li>Increased prolactin, galactorrhoea (rare)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li><strong>Srde\u010dn\u00ed selh\u00e1n\u00ed se sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed (HF-REF)<\/strong> \u2014 ne-DHP jsou kontraindikov\u00e1ny; mohou vyvolat akutn\u00ed dekompenzaci<\/li>\n<li><strong>AV blok druh\u00e9ho nebo t\u0159et\u00edho stupn\u011b<\/strong> bez funk\u010dn\u00edho kardiostimul\u00e1toru<\/li>\n<li><strong>Sinusov\u00e1 bradykardie &lt;50 tep\u016f\/min<\/strong><\/li>\n<li><strong>Syndrom nemocn\u00e9ho sinu<\/strong> bez kardiostimul\u00e1toru<\/li>\n<li><strong>Kardiogenn\u00ed \u0161ok<\/strong><\/li>\n<li><strong>T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za<\/strong><\/li>\n<li><strong>Wolff\u016fv-Parkinson\u016fv-White\u016fv syndrom s fibrilac\u00ed s\u00edn\u00ed<\/strong> \u2014 m\u016f\u017ee vyvolat rychl\u00fd p\u0159evod p\u0159es p\u0159\u00eddatnou dr\u00e1hu a fibrilaci komor<\/li>\n<li><strong>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed beta-blok\u00e1tor\u016f<\/strong> (b\u011b\u017en\u00e1 praxe) \u2014 aditivn\u00ed bradykardie\/blok srdce<\/li>\n<li>Known hypersensitivity to verapamil<\/li>\n<\/ul>\n<p><strong>T\u011bhotenstv\u00ed:<\/strong> nen\u00ed rutinn\u00ed l\u00e9\u010dbou prvn\u00ed volby. Verapamil se pou\u017e\u00edv\u00e1 u mate\u0159sk\u00e9 a fet\u00e1ln\u00ed SVT (proch\u00e1z\u00ed placentou). Diltiazem se v t\u011bhotenstv\u00ed obecn\u011b vyh\u00fdb\u00e1. Pro antihypertenzn\u00ed l\u00e9\u010dbu v t\u011bhotenstv\u00ed jsou, <a href=\"https:\/\/medsbase.com\/cs\/labebet\/\">labetalol<\/a>, methyldopa a nifedipin MR bezpe\u010dn\u011bj\u0161\u00edmi mo\u017enostmi.<\/p>\n<p><strong>Kojen\u00ed:<\/strong> mal\u00e9 mno\u017estv\u00ed se vylu\u010duje do ml\u00e9ka; obecn\u011b pova\u017eov\u00e1no za p\u0159ijateln\u00e9 s monitorov\u00e1n\u00edm kojence.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Beta-blok\u00e1tory<\/strong> \u2014 <strong>kontraindikov\u00e1no v rutinn\u00ed praxi.<\/strong> Aditivn\u00ed bradykardie, srde\u010dn\u00ed blok, riziko akutn\u00edho srde\u010dn\u00edho selh\u00e1n\u00ed. Pokud jsou oba l\u00e9ky nezbytn\u00e9, vy\u017eaduje kardiologick\u00fd dohled, monitorov\u00e1n\u00ed EKG a n\u011bkdy i z\u00e1lohu kardiostimul\u00e1torem.<\/li>\n<li><strong>Digoxin<\/strong> \u2014 ne-DHP zvy\u0161uj\u00ed hladinu digoxinu p\u0159ibli\u017en\u011b o 70 % (jak diltiazem, tak verapamil inhibuj\u00ed P-glykoprotein). Sni\u017ete d\u00e1vku digoxinu o 30-50 % p\u0159i p\u0159id\u00e1n\u00ed ne-DHP; kontrolujte hladiny.<\/li>\n<li><strong>Amiodaron<\/strong> \u2014 aditivn\u00ed riziko AV bloku<\/li>\n<li><strong>Siln\u00e9 inhibitory CYP3A4<\/strong> (ketokonazol, klarithromycin, ritonavir, grapefruitov\u00fd d\u017eus) \u2014 zvy\u0161uj\u00ed hladiny ne-DHP<\/li>\n<li><strong>Siln\u00e9 induktory CYP3A4<\/strong> (rifampicin, fenytoin, karbamazepin) \u2014 sni\u017euj\u00ed hladiny ne-DHP<\/li>\n<li><strong>Simvastatin, lovastatin<\/strong> \u2014 ob\u011b ne-DHP zvy\u0161uj\u00ed hladiny statin\u016f; omezte simvastatin na 20 mg\/den (10 mg\/den s verapamilem)<\/li>\n<li><strong>Cyklosporin, takrolimus<\/strong> \u2014 zv\u00fd\u0161eny ne-DHP (vyu\u017e\u00edv\u00e1no terapeuticky v transplanta\u010dn\u00ed medic\u00edn\u011b ke sn\u00ed\u017een\u00ed d\u00e1vky inhibitor\u016f kalcineurinu)<\/li>\n<li><strong>Dabigatran<\/strong> \u2014 verapamil zvy\u0161uje expozici dabigatranu; vyhn\u011bte se nebo sni\u017ete d\u00e1vku<\/li>\n<li><strong>Lithium<\/strong> \u2014 ne-DHP mohou zp\u016fsobit neurotoxicitu lithia; monitorujte hladiny lithia<\/li>\n<li><strong>Grapefruitov\u00e1 \u0161\u0165\u00e1va<\/strong> \u2014 inhibice CYP3A4 zvy\u0161uje plazmatick\u00e9 hladiny ne-DHP 1,5-2\u00d7<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">DHP vs ne-DHP CCB<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\"><\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">DHP (amlodipin, nifedipin)<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Non-DHPs (verapamil)<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Prim\u00e1rn\u00ed \u00fa\u010dinek<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Arteri\u00e1ln\u00ed vazodilataci<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vazodilatace + srde\u010dn\u00ed deprese<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Vliv na srde\u010dn\u00ed frekvenci<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">M\u00edrn\u00e9 reflexn\u00ed \u2191<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u2193 (u\u017eite\u010dn\u00e9 pro kontrolu frekvence p\u0159i fibrilaci s\u00edn\u00ed)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Kombinovat s betablok\u00e1torem?<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ano (standardn\u011b u anginy pectoris)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>NE<\/strong> (aditivn\u00ed bradykardie, blok)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Bezpe\u010dn\u00e9 u HF-REF?<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Amlodipin: ano<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>NE<\/strong> (negativn\u00ed inotropie)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Perifern\u00ed ed\u00e9m<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u010cast\u00e9 (10-25 %)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">M\u00e9n\u011b \u010dast\u00e9 (5-10 %)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Z\u00e1cpa<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">M\u00e9n\u011b \u010dast\u00e9<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u010cast\u00e9 (zejm\u00e9na u verapamilu)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte p\u0159i teplot\u011b do 25\u00b0C. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Why can&#8217;t I take Calaptin 40 with a beta-blocker?<\/h3>\n<p>Nedihydropyridinov\u00e9 blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f a beta-blok\u00e1tory OBA zpomaluj\u00ed AV nod\u00e1ln\u00ed veden\u00ed a sni\u017euj\u00ed srde\u010dn\u00ed kontraktilitu. Jejich kombinace vede k aditivn\u00edm \u00fa\u010dink\u016fm: bradykardii, prodlou\u017een\u00ed intervalu PR, AV blok\u00e1d\u011b druh\u00e9ho nebo t\u0159et\u00edho stupn\u011b a u vn\u00edmav\u00fdch pacient\u016f m\u016f\u017ee vyvolat srde\u010dn\u00ed selh\u00e1n\u00ed. Byly hl\u00e1\u0161eny i fat\u00e1ln\u00ed p\u0159\u00edpady. Pokud kontrola TK\/tepov\u00e9 frekvence vy\u017eaduje oba mechanismy, p\u0159ejd\u011bte na <strong>dihydropyridinov\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f<\/strong> (<a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">amlodipin<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/nicardia-retard\/\">nifedipin retard<\/a>), kter\u00fd je s beta-blok\u00e1tory bezpe\u010dn\u00fd.<\/p>\n<h3 class=\"wp-block-heading\">Why do I have new constipation on Calaptin 40?<\/h3>\n<p>Nedihydropyridinov\u00e9 blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f sni\u017euj\u00ed motilitu hladk\u00e9ho svalstva tr\u00e1vic\u00edho traktu (stejn\u00fd mechanismus, kter\u00fd uvol\u0148uje c\u00e9vn\u00ed hladk\u00e9 svalstvo). Z\u00e1cpa postihuje a\u017e 40 % u\u017eivatel\u016f verapamilu a men\u0161\u00ed procento u\u017eivatel\u016f diltiazemu. \u0158e\u0161en\u00ed: zv\u00fd\u0161it p\u0159\u00edjem vl\u00e1kniny, dostatek tekutin, \u0161etrn\u00e9 proj\u00edmadlo (laktul\u00f3za, makrogol). P\u0159i z\u00e1va\u017en\u00fdch pot\u00ed\u017e\u00edch zva\u017ete p\u0159echod na DHP nebo diltiazem (pokud u\u017e\u00edv\u00e1te verapamil).<\/p>\n<h3 class=\"wp-block-heading\">Can I take Calaptin 40 if I have atrial fibrillation?<\/h3>\n<p>Ano \u2013 nedihydropyridinov\u00e9 blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f jsou jednou ze standardn\u00edch mo\u017enost\u00ed pro <strong>kontrolu frekvence p\u0159i fibrilaci s\u00edn\u00ed<\/strong>, zejm\u00e9na u pacient\u016f, u kter\u00fdch jsou betablok\u00e1tory kontraindikov\u00e1ny (astma, t\u011b\u017ek\u00e9 perifern\u00ed c\u00e9vn\u00ed onemocn\u011bn\u00ed). Diltiazem i verapamil zpomaluj\u00ed veden\u00ed v AV uzlu a sni\u017euj\u00ed komorovou frekvenci. <strong>Kontraindikov\u00e1no u fibrilace s\u00edn\u00ed s Wolff-Parkinson-White syndromem<\/strong> \u2014 m\u016f\u017ee vyvolat fibrilaci komor.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Calaptin 40 if I have heart failure?<\/h3>\n<p>Obecn\u011b ne. Nedihydropyridinov\u00e9 blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f maj\u00ed negativn\u00ed inotropn\u00ed \u00fa\u010dinky, kter\u00e9 mohou vyvolat dekompenzaci u srde\u010dn\u00edho selh\u00e1n\u00ed se sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed (HF-REF). Pokud m\u00e1te HF-REF, vyhn\u011bte se nedihydropyridinov\u00fdm blok\u00e1tor\u016fm kalciov\u00fdch kan\u00e1l\u016f. <a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">Amlodipin<\/a> je preferovan\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f, pokud je pot\u0159eba u HF-REF (bezpe\u010dn\u00fd profil podle studi\u00ed PRAISE a V-HeFT-III).<\/p>\n<h3 class=\"wp-block-heading\">Can I use verapamil for cluster headache prophylaxis?<\/h3>\n<p>Yes &mdash; verapamil is one of the few evidence-based preventives for cluster headache. Typical dose 240-480 mg\/day (SR formulation), sometimes titrated higher (up to 960 mg\/day) under cardiology\/neurology supervision with ECG monitoring for PR prolongation. It is more effective than lithium, topiramate, or ergotamine for chronic and episodic cluster headache.<\/p>\n<h3 class=\"wp-block-heading\">Can I drink alcohol on Calaptin 40?<\/h3>\n<p>M\u00edrn\u00e1 konzumace alkoholu je obecn\u011b p\u0159ijateln\u00e1, ale alkohol zesiluje hypotenzn\u00ed a bradykardizuj\u00edc\u00ed \u00fa\u010dinky. Nadm\u011brn\u00e9 pit\u00ed samostatn\u011b zvy\u0161uje krevn\u00ed tlak a m\u011blo by se mu vyhnout.<\/p>\n<h3 class=\"wp-block-heading\">A co grapefruitov\u00fd d\u017eus?<\/h3>\n<p>Grapefruit (juice and fresh fruit) inhibits CYP3A4 metabolism and can raise verapamil plasma levels by 1.5-2&times;. Avoid on treatment days, or consume consistently &mdash; sporadic grapefruit disrupts BP\/HR control.<\/p>\n<h3 class=\"wp-block-heading\">Where can I buy Calaptin 40 online?<\/h3>\n<p>You can buy Calaptin 40 (verapamil 40 mg IR, 30-180 tablets) from MedsBase with discreet packaging and worldwide shipping.<\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed antihypertenziva na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/amlip\/\">Amlip \u2014 Amlodipin 2,5\/5 mg (DHP blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/amlode\/\">Amlode \u2014 Amlodipin 5\/10 mg (DHP blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/calaptin-sr\/\">Calaptin SR \u2014 Verapamil SR 120\/240 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/dilzem\/\">Dilzem \u2014 Diltiazem IR 30\/60 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/nicardia-retard\/\">Nicardia Retard \u2014 Nifedipin retard 10\/20\/30 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/nimodip-nimodipine\/\">Nimodip \u2014 Nimodipin (subarachnoid\u00e1ln\u00ed krv\u00e1cen\u00ed)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/vilano\/\">Vilano<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cosart-h\/\">Cosart H<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/flexabenz-er\/\">Flexabenz ER<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/dynapar\/\">Dynapar<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/meta-spray\/\">Meta Spray<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Calaptin 40 is verapamil 40 mg immediate-release tablets from Piramal \u2014 phenylalkylamine non-DHP CCB with the strongest cardiac effect in the class. For paroxysmal SVT (acute + chronic), AF rate control, hypertension, chronic stable angina, cluster headache prophylaxis, hypertrophic obstructive cardiomyopathy. 40 mg three times daily starter dose. DO NOT combine with beta-blocker; contraindicated in HF-REF and WPW with AF.<\/p>","protected":false},"featured_media":61140,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[4984,4985],"class_list":{"0":"post-61139","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-calaptin","11":"product_tag-verapamil","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/61139","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=61139"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/61140"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=61139"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=61139"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=61139"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=61139"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}