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Sular

Sular (generic name: nisoldipine) is a calcium channel blocker used to treat high blood pressure (hypertension). By relaxing the blood vessels, Sular helps lower blood pressure, which reduces the risk of strokes, heart attacks, and kidney problems. It works by inhibiting the influx of calcium ions into vascular smooth muscle and cardiac muscle, leading to relaxation and vasodilation.

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Frequently Asked Questions

How long does it take for Sular to start lowering blood pressure?
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Sular typically begins lowering blood pressure within 2 to 4 hours of taking the dose, but it may take several weeks for the full effects to be realized.

Can I take Sular with food?
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Sular should be taken on an empty stomach for best absorption. Food, especially high-fat meals, can alter the absorption of the medication and may increase the risk of side effects.

Can I drink alcohol while taking Sular?
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It is advisable to limit or avoid alcohol while taking Sular, as alcohol can increase the risk of side effects such as dizziness and low blood pressure.

What should I do if I miss a dose of Sular?
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If you miss a dose of Sular, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and take the next dose at your regular time. Do not take two doses at once to make up for a missed dose.

Can Sular cause swelling in the legs?
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Yes, peripheral edema (swelling of the hands, feet, or ankles) is a common side effect of Sular. If the swelling is severe or persistent, contact your healthcare provider for advice.

Comprehensive Drug Guide

How Does Sular Work?

Sular works by blocking calcium channels in the smooth muscle cells of blood vessels. This action reduces the contraction of blood vessels, leading to vasodilation (widening of the blood vessels), which lowers blood pressure. The reduction in vascular resistance also decreases the workload on the heart, making it easier for the heart to pump blood.

Common Dosages

  • 8.5 mg
  • 17 mg
  • 25.5 mg
  • 34 mg

Typical Dosing

  • The usual starting dose for hypertension is 17 mg once daily, with the dosage adjusted according to the patient's response.
  • The maximum recommended dose is 34 mg per day.

Sular should be taken once daily, preferably in the morning, and should be swallowed whole. Do not crush or chew the extended-release tablets.

Typical Dosing

FDA Approved Indications

  • The treatment of hypertension (high blood pressure).

Sular can be used alone or in combination with other antihypertensive agents to achieve better blood pressure control.

Who Shouldn't Take Sular?

  • Hypersensitivity to nisoldipine or any component of the formulation.
  • Severe hypotension (low blood pressure).

Advice From The Pharmacist

  • Take Sular on an empty stomach, as food (especially high-fat meals) can affect the absorption of the medication and increase the risk of side effects.
  • Do not consume grapefruit or grapefruit juice while taking Sular, as it can increase the levels of nisoldipine in the blood, potentially leading to side effects like dizziness or low blood pressure.
  • Do not abruptly stop taking Sular without consulting your doctor, as this can cause a sudden increase in blood pressure (rebound hypertension).

Side Effects of Sular

Common Side Effects

  • Headache
  • Dizziness or lightheadedness
  • Flushing (warmth, redness, or tingling)
  • Edema (swelling of the hands, feet, or ankles)
  • Fatigue

Uncommon/Severe Side Effects

  • Severe hypotension (low blood pressure)
  • Worsening chest pain (angina)
  • Heart palpitations
  • Allergic reactions, including rash, itching, or swelling

Risks and Warnings of Sular

  • Hypotension: Sular may cause a significant drop in blood pressure, particularly when starting the medication or increasing the dose. Patients should be monitored for signs of low blood pressure, such as dizziness or fainting.
  • Worsening of angina: In some cases, particularly when starting Sular or increasing the dose, patients with coronary artery disease may experience an increase in chest pain.
  • Hepatic Impairment: Patients with liver disease should be closely monitored, as Sular is metabolized in the liver, and its effects may be increased in those with impaired liver function.

Interactions with Sular

Common Drug Interactions

  • Grapefruit juice: Consuming grapefruit juice while taking Sular can increase the concentration of nisoldipine in the blood, leading to an increased risk of side effects such as low blood pressure or dizziness.
  • Beta-blockers: Co-administration with beta-blockers (e.g., metoprolol) can increase the risk of low blood pressure and heart-related side effects.
  • CYP3A4 inhibitors: Drugs that inhibit CYP3A4, such as ketoconazole, erythromycin, or ritonavir, can increase Sular's levels in the blood and raise the risk of side effects.

Alternatives to Sular

  • Amlodipine: Another calcium channel blocker often used for the treatment of hypertension and angina, with a similar mechanism of action.
  • Felodipine: Another extended-release calcium channel blocker that is used to treat high blood pressure.
  • Lisinopril: An ACE inhibitor used to treat high blood pressure and heart failure, often prescribed if calcium channel blockers are not effective or cause side effects.
  • Losartan: An angiotensin II receptor blocker (ARB) used for hypertension and heart protection.