Verelan Generic Name & Formulations
Legal Class
Rx
General Description
Verapamil HCl 120mg, 180mg, 240mg, 360mg; sust-rel caps.
Pharmacological Class
Calcium channel blocker (CCB) (diphenylalkylamine).
See Also
How Supplied
Caps—100
Manufacturer
Verelan Indications
Indications
Hypertension.
Verelan Dosage and Administration
Adult
Take as a single dose in the AM. May sprinkle contents on applesauce; do not crush or chew contents. ≥18yrs: usually 240mg daily; adjust in 120mg increments. Elderly, small people, others with increased sensitivity: 120mg daily; if needed, may increase daily dose to 180mg, then 240mg, then higher in 120mg increments. Max 480mg daily.
Children
<18yrs: not established.
Verelan Contraindications
Contraindications
Severe left ventricular (LV) dysfunction (eg, ejection fraction <30%, moderate to severe heart failure). LV dysfunction treated with β-blockers. Hypotension. Cardiogenic shock. Sick sinus syndrome, 2nd- or 3rd-degree AV block, unless paced. Atrial flutter or fibrillation. Accessory bypass tract (eg, Wolff-Parkinson-White, Lown-Ganong-Levine syndromes).
Verelan Boxed Warnings
Not Applicable
Verelan Warnings/Precautions
Warnings/Precautions
Control mild ventricular dysfunction (eg, with digitalis, diuretics) prior to initiation. AV conduction or neuromuscular transmission disorders. Hepatic or renal impairment. Monitor liver function periodically. Hypertrophic cardiomyopathy. Pregnancy (Cat.C). Nursing mothers: not recommended.
Verelan Pharmacokinetics
See Literature
Verelan Interactions
Interactions
Avoid ivabradine; disopyramide (within 48hrs before or 24hrs after verapamil); quinidine in cardiomyopathy. Limit simvastatin dose to 10mg/day or lovastatin to 40mg/day; may need to reduce initial and maintenance dose for other CYP3A4 substrates (eg, atorvastatin). Potentiates alcohol, β-blockers (monitor closely), other antihypertensives (monitor), theophylline, neuromuscular blockers, flecainide, carbamazepine, cyclosporine, doxorubicin. Consider reducing concomitant digoxin dose; monitor periodically; discontinue if toxicity suspected. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir), grapefruit juice. Antagonized by CYP3A4 inducers (eg, rifampin, phenobarbital). Inhalation anesthetics may potentiate cardiac depression. May increase bleeding with aspirin. Monitor lithium levels. Monitor heart rate when concomitant clonidine. Concomitant mTOR inhibitors (eg, sirolimus, temsirolimus, everolimus): consider dose reductions of both drugs.
Verelan Adverse Reactions
Adverse Reactions
Headache, infection, constipation, flu syndrome, peripheral edema, dizziness, pharyngitis, sinusitis, lethargy, dyspepsia; CHF, hypotension, AV block, elevated liver enzymes; rare: paralytic ileus.
Verelan Clinical Trials
See Literature
Verelan Note
Not Applicable
Verelan Patient Counseling
See Literature