Verapamil is a calcium channel blocker, a drug with antiarrhythmic, antianginal and antihypertensive effects.
Release form and composition
The drug is available in the form of dragees and film-coated tablets for oral administration, as well as in the form of a solution for intravenous administration.
The composition of one pills Verapamil includes:
- 40 or 80 mg verapamil (in the form of hydrochloride);
- Excipients: potato starch, lactose, avicel, magnesium stearate, gum arabic, sucrose, gelatin, silica, talc, polyvidone K25, paraffin, polyethylene glycol and Chinolingelblack E 104.
The composition of one tablet Verapamil includes:
- 40 or 80 mg of verapamil hydrochloride;
- Additional components: methyl paraben, calcium phosphate disubstituted, hydroxypropyl methylcellulose, starch, purified talc, titanium dioxide, butyl hydroxyanisole, magnesium stearate, gelatin and indigo carmine.
The composition of one ampoule (2 ml) Verapamil includes:
- 5 mg of verapamil hydrochloride (respectively, in 1 ml - 2.5 mg);
- Excipients: citric acid monohydrate, sodium chloride, concentrated hydrochloric acid, sodium hydroxide, injectable water.
Indications for use
According to the instructions to Verapamil, in the form of pills and tablets, this drug is prescribed for:
- Treatment and prevention of cardiac arrhythmias: atrial fibrillation and flutter (tachyarrhythmic variant), supraventricular paroxysmal tachycardia, supraventricular extrasystole;
- Treatment and prevention of chronic stable and unstable angina pectoris (angina pectoris and rest angina pectoris), vasospastic angina pectoris;
- Therapy of arterial hypertension.
Verapamil solution is used to relieve attacks of supraventricular paroxysmal tachycardia, atrial extrasystole, paroxysmal flutter, and atrial fibrillation.
The use of Verapamil, according to the instructions, is contraindicated in children and adolescents under 18 years old, as well as in patients with:
- Chronic heart failure in stage IIB and III;
- Severe bradycardia;
- Morgagni-Adams-Stokes Syndrome;
- Synotrial blockade;
- Cardiogenic shock (with the exception of shock caused by arrhythmia);
- Sick sinus syndrome;
- AV blockade II and III degrees without artificial pacemakers;
- Wolff-Parkinson-White syndrome;
- Acute heart failure;
- The presence of hypersensitivity to verapamil hydrochloride or any auxiliary component;
- Pregnancy and breastfeeding.
In addition, contraindications for intravenous administration of verapamil are:
- The simultaneous use of beta-blockers;
- Aortic stenosis;
- Digitalis intoxication;
- Ventricular tachycardia;
Prescribed medication, but with extreme caution to the elderly, as well as patients with:
- Severe impaired liver function;
- Hypotension if the systolic pressure does not reach 100 mmHg. (for tablets);
- AV block I degree;
- Myocardial infarction with left ventricular failure;
- Chronic heart failure I-II degrees.
Dosing and Administration
Pills and tablets Verapamil should be taken with food or immediately after a meal.
The specific dosage and duration of treatment in each case are set individually, taking into account the general condition of the patient, the characteristics of the course and severity of the disease, as well as the effectiveness of the therapy. As a rule, the drug is prescribed in 40-80 mg (1-2 pills / tablets) three or four times a day. If necessary, a single dose is gradually increased to 160 mg, but not more than 480 mg per day.
In case of abnormal liver function, the elimination of verapamil hydrochloride from the body slows down, therefore, in this case, treatment is recommended to start with a minimum dose. The maximum allowable daily dosage for these patients is 120 mg.
The solution of Verapamil is administered intravenously slowly (at least 2 minutes), continuously monitoring the electrocardiogram, blood pressure, heart rate. For older people, in order to reduce the risk of side effects, the injection should be done for at least 3 minutes.
For stopping paroxysmal arrhythmias, jet injection of the drug is allowed (under the control of ECG and blood pressure) in a volume of 2-4 ml of a 0.25% solution (diluted with 0.9% sodium chloride solution).
The use of verapamil may be accompanied by the following side effects:
- Severe bradycardia, facial flushing, arterial hypotension, AV-blockade, when using high doses - symptoms of heart failure;
- Nausea, vomiting, constipation, rarely - transient increase in liver transaminase activity;
- Headache, dizziness, rarely - lethargy, increased fatigue and nervous irritability;
- The development of peripheral edema;
- Allergic reactions.
In the period of use of Verapamil, the functions of the respiratory and cardiovascular systems, the level of electrolytes and glucose in the blood, the amount of urine excreted, the volume of circulating blood should be monitored.
The drug can reduce the speed of reactions, it should be taken into account drivers and people whose professional activity is associated with increased concentration of attention.
The antihypertensive effect of verapamil is enhanced by diuretics and antihypertensive drugs.
Structural analogues of Verapamil are the following drugs: Verapamil Sofarma, Verapamil-Ferein, Verapamil-Eskom, Verogalid EP 240, Isoptin, Isoptin CP, Finoptin.
Terms and conditions of storage
Verapamil is a prescription drug. Both tablets and ampoules should be stored in a place protected from sunlight. The optimum storage temperature is from 15 to 25 ºС. The shelf life of both dosage forms - 3 years.