Verapamil

Brand names of verapamil

  • Alti-Verap
  • Apo-Verap
  • Calan
  • Calan SR
  • Chronovera
  • Covera-HS
  • Dom-Verapamil SR
  • Gen-Verapamil
  • Isoptin
  • Isoptin SR
  • Med-Verapamil
  • Novo-Veramil
  • Nu-Verap
  • PMS-Verapamil
  • Tarka [CD]
  • Verelan
  • Verelan PM

Verapamil is a calcium channel blocker or calcium antagonist of the L-type and belongs to the class of drugs called phenylalkylamine. This medication has been employed for treating high blood pressure, cardiac arrhythmia and angina pectoris (heart pain). In very recent times, verapamil has also been used to treat cluster headaches (also known as histamine headaches). This medication is also effective in putting off the occurrence of migraines. In addition, this drug has also been employed in the form of a vasodilator in the course of blood vessels' cryopreservation (keeping the blood vessels working even at extremely low temperatures). Verapamil is an antiarrhythmic of class IV type and further effectual compared to digoxin in regulating ventricular rhythm. In March 1982, the Food and Drug Administration (FDA) approved the sale and use of verapamil in the USA.

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Things you need to tell your physician before taking verapamil

Ahead of starting therapy with verapamil, tell your physician plus your pharmacist whether you have allergies to this medicament, any component of this drug; any other drug; or have any additional allergies. Some contents of verapamil may cause allergies or additional health problems. Therefore, if you are not sure about the ingredients of verapamil, ask your pharmacist to provide you with the list of its contents.

People having specific health conditions should not use verapamil. So, you should tell your physician if you are suffering from particular problems related to the heart rhythm (for instance, sick sinus syndrome provided you are without a pacemaker; atrioventricular blockage of the second-degree or third-degree; Lown-Ganong-Levine syndrome; and Wolff-Parkinson-White syndrome).

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Prior to taking verapamil for the very first time, let your physician know about your whole medical history, particularly if you have or earlier had any liver or kidney ailment; specific problems related to the nerves/muscle (for instance, myasthenia gravis, muscular dystrophy); heart failure; constriction or blockage of the stomach and/ or the intestines.

Similar to other calcium channel blockers, verapamil too may cause dizziness. Therefore, you should not undertake activities requiring alertness, for instance driving or operating machines, till you are certain about the consequences of the drug on your body and till the time when you are sure that you are able to execute these activities in a safe way. People taking verapamil should essentially restrict their alcohol consumption.

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If you require having a surgery, let your surgeon know beforehand that you are using verapamil.

Pregnant women should strictly use verapamil only when it is absolutely necessary for their condition. Before taking this medicament, they should consult their physician regarding the advantages and risks of using it during pregnancy. Although verapamil enters breast milk, it is not likely to cause any harm to the nursing baby. Nevertheless, before breast feeding, you need to talk to your physician regarding the advantages and hazards of taking it.

Usage

The L-type calcium antagonist verapamil has a number of therapeutic uses. This drug is prescribed for treating angina pectoris (heart pain related to a heart ailment), high blood pressure and irregular heart rhythms (cardiac arrhythmias).

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How to use verapamil

Verapamil is available in three different forms - standard tablets, extended release or long-acting tablets as well as extended release capsules and is taken orally. While the normal tablet is taken anything between three and four times every day, the long-acting tablets and capsules are generally taken twice daily. Like most other prescription drugs, verapamil should be taken at about similar time(s) daily. Different verapamil products are taken at different times - while some ought to be taken during the morning, there are others that need to be taken before retiring to bed at night. Therefore, you should seek the advice of your physician regarding the appropriate time to take the verapamil product you are using. Strictly abide by the instructions given on the product prescription label and seek the help of your physician or pharmacist if you are unable to comprehend any instruction. You should take verapamil precisely as you have been prescribed and never take the drug in excessive or less dosage or more frequently than what your physician has recommended.

Do not break, chew or crush the long-acting verapamil tablets or capsules, but gulp them down as a whole. Since the instructions of different verapamil products differ, you may seek the advice of your pharmacist if you are permitted to break the standard verapamil tablets into half.

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Provided you are unable to gulp down verapamil extended release capsules with water, you may open the capsule cautiously and sprinkle its content on applesauce and take it. Ensure that the applesauce is not warm and is sufficiently soft so that you can swallow it without chewing soon after sprinkling the whole content of the capsule on it. Drink one glass (about 8 oz) of cold water after swallowing the medication with applesauce. Never keep the mixture for later use.

Normally, your physician is likely to prescribe verapamil in a low dose in the beginning and slowly enhance the dosage to the most appropriate level for you.

It is worth mentioning here that while verapamil is effective in regulating hypertension, arrhythmias and angina pectoris, it is not helpful for curing these health conditions. Even when you start feeling better after starting therapy with verapamil, you need to keep on taking the medication. Never discontinue this drug without talking to your physician first.

How verapamil works

Verapamil works by obstructing the transportation of calcium to the cells of the heart muscle as well as smooth muscle present in the artery walls. This action of the drug loosen the blood vessels enabling them to become broader, thereby reducing blood pressure, enhancing the supply of blood to the heart and, at the same time, reducing the general burden of the heart.

Side effects

Serious:
  • breathing difficulty
  • chest pain
  • coughing
  • extreme dizziness
  • fainting
  • irregular or pounding heartbeat
  • wheezing
Common:
Less common:

Possible interactions

Herbal medicines or minerals:
Using ginseng in combination with verapamil is likely to raise blood pressure, thereby dulling the advantages of using the medicine. Licorice, ma huang, yohimbe, saw palmetto, hawthorn and goldenseal may also result in high blood pressure. Garlic as well as calcium may lower the blood pressure and using either of them in conjunction with verapamil may lessen the dosage of this drug. On the other hand, St. John's wort is likely to lower the levels of calcium channel blockers. Moreover, using verapamil with St. John's wort will possibly augment sensitivity to sunlight. People who have high blood pressure should always avoid using Siberian ginseng root.
It is essential to seek the advice of your physician before incorporating any herbal product into your existing list of medicaments.
Foods:
If you are using verapamil you should avoid taking grapefruit or its juice and also keep away from ingesting too much salt.
Beverages:
Avoid taking beverages containing caffeine when you are being treated with verapamil, as this medication will raise the levels of caffeine in the bloodstream.
Alcohol:
Using alcohol while taking verapamil is likely to result in further lowering of the blood pressure and also alter the removal of alcohol from the body. In fact, a number of patients have reported this problem. At the same time, using this combination may also intensify the consequences of consuming alcohol.
Tobacco smoking:
Keep away from smoking tobacco while taking verapamil, because nicotine has the aptitude to diminish this medication's efficiency.
Marijuana smoking:
Smoking marijuana while using verapamil may possibly diminish the effect of this drug; result in gentle to restricted enhancement in angina; is also likely to bring about alterations in electrocardiogram and misleading readings.
Exposure to heat:
Coming in contact with hot surroundings while using verapamil may possibly strengthen this medication's actions to lower blood pressure.
Exposure to sun:
People taking verapamil should avoid exposure to the sun, as this medicament has the aptitude to augment photosensitivity.
Heavy exercise or exertion:
People using verapamil should know that this drug is likely to enhance their competence in becoming further active with no angina pain. Hence, they need to be careful and stay away from undertaking too much exercise that may harm the functioning of the heart without any warning angina pain.

Discontinuation

Verapamil should never be discontinued all of a sudden and also without consulting your physician. When you want to stop taking this medicament talk to your physician about slowly decreasing its dose with a view to avoid rebound angina from occurring.

Storage instructions

Keep verapamil at normal room temperature ranging between 20°C and 25°C and in a place further than light and humidity. It is not advisable to store this medication in your bathroom medicine cabinet. It is essential to store all medications away from the accessibility of children as well as pets.

Always dispose of medications that are required no longer or have lapsed their expiry date in a safe and proper manner. Unless you have been advised otherwise, do not discard them by flushing down your toilet or pouring into a drain. If necessary, you may ask your pharmacist or any waste disposal firm in your locality to help you to dispose of such medications safely.

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