Brand names include: Calaptin / Isoptin / Verelan / Calan / Bosoptin

Active ingredient: verapamil hydrochloride.

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Verapamil is a medical product used in cardiology for the treatment of hypertension and other cardiovascular diseases. Verapamil has no specific pharmacological properties. It can be used in combination with other drugs to enhance the therapeutic effect.

Verapamil provides hypotensive, antiarrhythmic, antianginal pharmacological action. The mechanism of the hypotensive action is conditioned by the dilation of the coronary vessels  due to which the blood flow is increased, the need of myocardium in oxygen is reduced, and the arterial pressure is lowered.

The antiarrhythmic action consists in the reduction of the heart rate and inhibition of the atrioventricular conduction. Moreover, Verapamil provides some diuretic action by means of the reduction of the tubular reabsorption.

Therapeutic effect develops slowly during 2 hours after usage. As a result the drug may be taken as a preventive medication o chronic forms of hypertension, but it cannot reduce the pressure in hypertensive crises.

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Directions for the use

  • Angina
  • Tachycardia
  • Tachyarrhythmias
  • Atrial flutter
  • Hypertension
  • Chronic ischemic heart disease

Verapamil can be used in combination therapy for the treatment of other cardiovascular diseases that are not specified in this manual. The dosing of drugs should be adjusted when using in combination therapy.

Dosage and way of use

  • Verapamil Tablets are for oral use, before eating (at least 30 minutes before meal) with a full glass of water
  • It is necessary to start the treatment with minimal doses, gradually increasing the dosage until the optimal safe level.
  • The starting dose of Verapamil is 40 mg 3 times per day.
  • In case of the absence of positive therapeutic effect, the unit dose can be increased up to 80-120 mg
  • The average daily dose can be 240-480 mg, depending on the form of the cardiovascular disease and the response of the patient to treatment.
  • After reaching the positive therapeutic effect, patients are advised to the supportive therapy. Supportive therapy (smaller, individually prescribed doses) can last long enough.
  • Children under 14 years must have selected dosage, solely on the basis of the individual characteristics of the child, age, weight and form of the disease.
  • Average dose for children 6-14 years old is 40 mg 2-3 times a day; for children under 6 years old is 20 mg 2-3 times a day.
  • Children under 2 years old can take Verapamil intravenously.

Precautions

  • Contraindications for the use of Verapamil are: Hypotension, cardiac shock, recent acute myocardial infarction.
  • The daily dose should be adjusted in case of liver and \ or renal insufficiency.
  • During pregnancy and breastfeeding, Verapamil is permissible to take only in the absence of alternative treatments, and only under the supervision of a qualified health professional.
  • With the simultaneous use of several antihypertensive drugs, there can be a strengthening of antihypertensive action, so the requiring reduction of the daily dose of each drug is required.

Possible Side effects

Verapamil is well tolerated and adverse reactions are extremely rare, and can be noticed only in case of individual intolerance of the drug’s components.

The most likely adverse reactions are nausea, vomiting, dizziness, fatigue, development of peripheral edema, a fast decrease in blood pressure, drowsiness and constipation.

The clinical studies of the active substances of Verapamil show that the side effects are disappear within 5-7 days after beginning of treatment and do not interfere with therapy.