Share on Facebook
Share on Twitter
Share on LinkedIn
Share by Email
Print
Verapamil Generic Name & Formulations
Legal Class
Rx
General Description
Verapamil HCl 40mg, 80mg+, 120mg+; tabs; +scored.
Pharmacological Class
Calcium channel blocker (CCB) (diphenylalkylamine).
See Also
How Supplied
Contact supplier
Manufacturer
Mechanism of Action
Verapamil is a calcium ion influx inhibitor (slow-channel blocker or calcium ion antagonist) that exerts its pharmacologic effects by modulating the influx of ionic calcium across the cell membrane of the arterial smooth muscle as well as in conductile and contractile myocardial cells.
Verapamil Indications
Indications
Vasospastic, unstable and chronic stable angina.
Verapamil Dosage and Administration
Adult
Initially 80–120mg 3 times daily, increase daily or weekly if needed; max 480mg daily. Elderly or small patients: initially 40mg 3 times daily.
Children
<18yrs: not established.
Verapamil Contraindications
Contraindications
Severe left ventricular (LV) dysfunction or LV dysfunction treated with β-blockers. Moderate to severe heart failure. Hypotension. Cardiogenic shock. Sick sinus syndrome, 2nd- or 3rd-degree AV block, unless paced. Atrial flutter or fibrillation and an accessory bypass tract.
Verapamil Boxed Warnings
Not Applicable
Verapamil Warnings/Precautions
Warnings/Precautions
Control mild ventricular dysfunction (eg, with digitalis, diuretics) before initiation. AV conduction or neuromuscular transmission disorders. Hepatic or renal impairment. Monitor liver function periodically. Hypertrophic cardiomyopathy. Pregnancy. Nursing mothers: not recommended.
Verapamil Pharmacokinetics
See Literature
Verapamil Interactions
Interactions
Potentiates alcohol, β-blockers, other antihypertensives, digitalis, theophylline, neuromuscular blockers, flecainide, carbamazepine, cyclosporine, lovastatin (limit to max 40mg/day), simvastatin (limit to max 10mg/day), atorvastatin (use lower doses). Avoid ivabradine; quinidine in hypertrophic cardiomyopathy; disopyramide within 48hrs before or 24hrs after verapamil. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir), grapefruit juice; antagonized by CYP3A4 inducers (eg, phenobarbital, rifampin). Inhalation anesthetics may potentiate cardiac depression. May increase bleeding with aspirin. Monitor theophylline, lithium. Concomitant mTOR inhibitors (eg, sirolimus, temsirolimus, everolimus); consider dose reductions of both drugs. Monitor heart rate with concomitant clonidine.
Verapamil Adverse Reactions
Adverse Reactions
Constipation, dizziness, nausea, hypotension, headache, edema, CHF, fatigue, dyspnea, bradycardia, AV block, rash, flushing, elevated liver enzymes; rare: paralytic ileus.
Verapamil Clinical Trials
See Literature
Verapamil Note
Not Applicable
Verapamil Patient Counseling
See Literature
Verapamil Generic Name & Formulations
Legal Class
Rx
General Description
Verapamil HCl 40mg, 80mg+, 120mg+; tabs; +scored.
Pharmacological Class
Calcium channel blocker (CCB) (diphenylalkylamine).
See Also
How Supplied
Contact supplier
Manufacturer
Mechanism of Action
Verapamil is a calcium ion influx inhibitor (slow-channel blocker or calcium ion antagonist) that exerts its pharmacologic effects by modulating the influx of ionic calcium across the cell membrane of the arterial smooth muscle as well as in conductile and contractile myocardial cells.
Verapamil Indications
Indications
Control (with digitalis) of ventricular rate in patients with chronic atrial flutter and/or fibrillation. Prophylaxis of repetitive paroxysmal supraventricular tachycardia (PSVT).
Verapamil Dosage and Administration
Adult
Digitalized patients with chronic atrial fibrillation: 240mg–320mg/day in 3–4 divided doses. Prophylaxis of PSVT (non-digitalized patients): 240mg–480mg/day in 3–4 divided doses.
Children
<18yrs: not established.
Verapamil Contraindications
Contraindications
Severe left ventricular (LV) dysfunction or LV dysfunction treated with β-blockers. Moderate to severe heart failure. Hypotension. Cardiogenic shock. Sick sinus syndrome, 2nd- or 3rd-degree AV block, unless paced. Atrial flutter or fibrillation and an accessory bypass tract.
Verapamil Boxed Warnings
Not Applicable
Verapamil Warnings/Precautions
Warnings/Precautions
Control mild ventricular dysfunction (eg, with digitalis, diuretics) before initiation. AV conduction or neuromuscular transmission disorders. Hepatic or renal impairment. Monitor liver function periodically. Hypertrophic cardiomyopathy. Pregnancy. Nursing mothers: not recommended.
Verapamil Pharmacokinetics
See Literature
Verapamil Interactions
Interactions
Potentiates alcohol, β-blockers, other antihypertensives, digitalis, theophylline, neuromuscular blockers, flecainide, carbamazepine, cyclosporine, lovastatin (limit to max 40mg/day), simvastatin (limit to max 10mg/day), atorvastatin (use lower doses). Avoid ivabradine; quinidine in hypertrophic cardiomyopathy; disopyramide within 48hrs before or 24hrs after verapamil. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir), grapefruit juice; antagonized by CYP3A4 inducers (eg, phenobarbital, rifampin). Inhalation anesthetics may potentiate cardiac depression. May increase bleeding with aspirin. Monitor theophylline, lithium. Concomitant mTOR inhibitors (eg, sirolimus, temsirolimus, everolimus); consider dose reductions of both drugs. Monitor heart rate with concomitant clonidine.
Verapamil Adverse Reactions
Adverse Reactions
Constipation, dizziness, nausea, hypotension, headache, edema, CHF, fatigue, dyspnea, bradycardia, AV block, rash, flushing, elevated liver enzymes; rare: paralytic ileus.
Verapamil Clinical Trials
See Literature
Verapamil Note
Not Applicable
Verapamil Patient Counseling
See Literature
Verapamil Generic Name & Formulations
Legal Class
Rx
General Description
Verapamil HCl 40mg, 80mg+, 120mg+; tabs; +scored.
Pharmacological Class
Calcium channel blocker (CCB) (diphenylalkylamine).
See Also
How Supplied
Contact supplier
Manufacturer
Mechanism of Action
Verapamil is a calcium ion influx inhibitor (slow-channel blocker or calcium ion antagonist) that exerts its pharmacologic effects by modulating the influx of ionic calcium across the cell membrane of the arterial smooth muscle as well as in conductile and contractile myocardial cells.
Verapamil Indications
Indications
Hypertension.
Verapamil Dosage and Administration
Adult
Initially 80mg 3 times daily; usual max 360mg/day in divided doses. Elderly or small patients: initially 40mg 3 times daily.
Children
<18yrs: not established.
Verapamil Contraindications
Contraindications
Severe left ventricular (LV) dysfunction or LV dysfunction treated with β-blockers. Moderate to severe heart failure. Hypotension. Cardiogenic shock. Sick sinus syndrome, 2nd- or 3rd-degree AV block, unless paced. Atrial flutter or fibrillation and an accessory bypass tract.
Verapamil Boxed Warnings
Not Applicable
Verapamil Warnings/Precautions
Warnings/Precautions
Control mild ventricular dysfunction (eg, with digitalis, diuretics) before initiation. AV conduction or neuromuscular transmission disorders. Hepatic or renal impairment. Monitor liver function periodically. Hypertrophic cardiomyopathy. Pregnancy. Nursing mothers: not recommended.
Verapamil Pharmacokinetics
See Literature
Verapamil Interactions
Interactions
Potentiates alcohol, β-blockers, other antihypertensives, digitalis, theophylline, neuromuscular blockers, flecainide, carbamazepine, cyclosporine, lovastatin (limit to max 40mg/day), simvastatin (limit to max 10mg/day), atorvastatin (use lower doses). Avoid ivabradine; quinidine in hypertrophic cardiomyopathy; disopyramide within 48hrs before or 24hrs after verapamil. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir), grapefruit juice; antagonized by CYP3A4 inducers (eg, phenobarbital, rifampin). Inhalation anesthetics may potentiate cardiac depression. May increase bleeding with aspirin. Monitor theophylline, lithium. Concomitant mTOR inhibitors (eg, sirolimus, temsirolimus, everolimus); consider dose reductions of both drugs. Monitor heart rate with concomitant clonidine.
Verapamil Adverse Reactions
Adverse Reactions
Constipation, dizziness, nausea, hypotension, headache, edema, CHF, fatigue, dyspnea, bradycardia, AV block, rash, flushing, elevated liver enzymes; rare: paralytic ileus.
Verapamil Clinical Trials
See Literature
Verapamil Note
Not Applicable
Verapamil Patient Counseling
See Literature
