Bepridil Hydrochloride

• Type of Drug:Calcium channel blocker.
• Prescribed for: Prevention of angina-type heart pains.

General Information

Bepridil is one of many calcium channel blockers available in the United States. These drugs work by blocking the passage of calcium into heart and smooth muscle. Since calcium is an essential factor in muscle contraction, any drug that affects calcium in this way will interfere with the contraction of these muscles. When this happens, the amount of oxygen used by the muscles is also reduced. Therefore, Bepridil is used to treat angina, a type of heart pain related to poor oxygen supply to the heart muscles. Bepridil affects the movement of calcium only into muscle cells. It does not have any effect on calcium in the blood. Other calcium channel blockers are used for high blood pressure, abnormal heart rhythms, diseases involving blood vessel spasm (migraine headache, Raynaud’s syndrome), heart failure, and cardiomyopathy.

Cautions and Warnings

Do not take this drug if you have had an allergic reaction to it. It should be used with extreme caution if you have a history of problems related to heart rhythm.

Bepridil has caused serious derangement of heart rhythm and has affected white-blood-cell counts; therefore, it is usually reserved only for people who do not respond to other treatments.

Low blood pressure may occur, especially in people also taking a beta blocker.

Use Bepridil with caution if you have heart failure, since the drug can worsen the condition. Bepridil may cause angina pain when treatment is first started, when dosage is increased, or if the drug is rapidly withdrawn. This can be avoided by gradual dosage reduction.

Studies have shown that people taking calcium channel blockers (usually those taken several times a day, not those taken only once daily) have a greater chance of having a heart attack than people taking beta blockers or other medicines for the same purposes. Discuss this with your doctor to be sure you are receiving the best possible treatment.

Calcium channel blockers can affect blood platelets, leading to possible bruising, black-and-blue marks, and bleeding.

People with serious liver disorders should use this product with care because it is primarily eliminated from the body by breakdown in the liver. Drug dosage should be reduced.
People with kidney problems need to have their Bepridil dosage adjusted because the drug’s breakdown products pass out of the body through the kidneys.

Possible Side Effects

Calcium channel blocker side effects are generally mild and rarely cause people to stop taking them.

• Most common: diarrhea, nausea, and lightheadedness.
• Less common: abnormal heart rhythms, very slow or very rapid heartbeat, breathing difficulty, coughing or wheezing (possible signs of lung congestion or heart failure), constipation, headache, and unusual tiredness or weakness.
• Rare: low blood pressure, fainting, and swelling in the ankles, feet, or legs. Other rare side effects can affect a wide variety of body systems. Gall your doctor if something unusual develops.

Drug Interactions

• Bepridil may interact with the beta-blocking drugs to cause heart failure, very low blood pressure, or an increased incidence of angina pain. However, in many cases these drugs have been taken together with no problem.
• Bepridil may, in rare instances, increase the effects of anticoagulant (blood-thinning) drugs.
• Some calcium channel blockers may increase the amount of Digoxin in the blood, but this interaction does not occur with Bepridil.
• Additional drug interactions occur with other members of this class but have not been seen with Bepridil.

Food Interactions

Taking Bepridil with food has a minor effect on the absorption of the drug. You may take it with food if it upsets your stomach.

Usual Dose

200 to 400 mg per day in 2 doses. Do not stop taking this drug abruptly. The dosage should be gradually reduced over a period of time.

Overdosage

Overdose of Bepridil can cause nausea, dizziness, weakness, drowsiness, confusion, slurred speech, very low blood pressure, reduced heart efficiency, and unusual heart rhythms. Victims of a Bepridil overdose should be taken to a hospital emergency room for treatment. ALWAYS bring the medicine bottle.

Special Information

Call your doctor if you develop swelling in the arms or legs, difficulty breathing, abnormal heartbeat, increased heart pains, dizziness, constipation, nausea, light-headedness, or very low blood pressure.
If you forget to take a dose of Bepridil, take it as soon as you remember. If it is almost time for your next regularly scheduled dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.

Special Populations

Pregnancy/Breast-feeding
Very high doses of Bepridil have been found to affect the development of animal fetuses in laboratory studies. Bepridil has not caused human birth defects, but pregnant women, or those who might become pregnant while taking this drug, should take it only with their doctor’s approval. When the drug is considered essential by your doctor, the potential risk of taking the medicine must be carefully weighed against the benefit it might produce.
Bepridil passes into breast milk. This drug has caused no problems among breast-fed infants. However, if you must take Bepridil, you should consider the potential effect on your infant before nursing.

Seniors
No problems have been reported in older adults. However, older adults are likely to have age-related reduction in kidney or liver function. This factor should be taken into account by your doctor when determining the dosage of this medication. Follow your doctor’s directions and report any side effects at once. Older adults require more frequent monitoring by their doctors after treatment has started.