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Calcium Channel Blockers 24 HOUR URGENT PRIOR AUTHORIZATION REQUEST FORM SECTION A PATIENT INFORMATION Today's Date: Member ID #: City: Phone: Primary Insurance: Complete ENTIRE form and Fax to: 8669407328
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How to fill out calcium channel blockers

01
Read the medication label and patient information leaflet carefully before starting.
02
Wash your hands and gather all the necessary supplies.
03
Identify the recommended dosage of the specific calcium channel blocker you have been prescribed.
04
Use a pill cutter or crusher if required to adjust the dosage as prescribed.
05
Take the calcium channel blocker with or without food, as directed by your healthcare provider.
06
Swallow the tablet or capsule whole with a glass of water. Do not crush or chew unless your doctor instructs you to.
07
Take the medication at the same time(s) every day to help you remember.
08
If you forget a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule.
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Do not suddenly stop taking the calcium channel blocker without consulting your doctor, as this may cause adverse effects.
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Inform your healthcare provider about any other medications or supplements you are taking to avoid potential interactions.

Who needs calcium channel blockers?

01
Individuals with high blood pressure (hypertension) may need calcium channel blockers to help lower their blood pressure and reduce the risk of heart events.
02
People with certain heart conditions, such as angina or arrhythmia, may require calcium channel blockers to manage their symptoms and improve heart function.
03
Calcium channel blockers are also prescribed to individuals with Raynaud's disease, a condition that causes blood vessels in the fingers and toes to spasm, leading to pain and numbness.
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Patients with certain types of migraines may benefit from using calcium channel blockers to prevent and reduce the frequency of these headaches.
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Depending on the individual's medical history and condition, doctors may recommend calcium channel blockers as part of the treatment plan. It is essential to consult a healthcare professional for personalized advice.
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Calcium channel blockers are medications that are commonly used to treat high blood pressure and certain heart conditions by blocking calcium from entering the cells of the heart and blood vessels.
Healthcare providers are required to file calcium channel blockers prescriptions for their patients.
To fill out calcium channel blockers, healthcare providers need to document the name of the medication, dosage, frequency of administration, and patient information.
The purpose of calcium channel blockers is to relax the blood vessels and decrease the heart's workload, which helps to lower blood pressure and improve blood flow.
The information that must be reported on calcium channel blockers includes the patient's name, date of birth, medical history, current medications, and any existing conditions.
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