Verapamil

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NPPA
Regulated

Molecule Description

Verapamil is a Calcium Channel Blocker (CCB) that relaxes the muscles of the heart and blood vessels. It is prescribed in cases of high blood pressure, chest pain and disorders in heart rhythm. Its action is more selective for the heart muscles as compared to other CCBs.

Uses

Verapamil is used to treat the following conditions:
High blood pressure (hypertension)
Chest pain (angina)
Heart rhythm disorders (arrhythmias)
Atrial fibrillation/ flutter
Migraine
Secondary prevention of myocardial infarction

Contraindications

When should one not use Verapamil

Allergy to Verapamil
Heart failure
Low blood pressure
If you often faint along with slow heartbeats
If you suffer from a condition known as sick sinus syndrome or atrioventricular block
Any problem in the heart chambers

Side effects

Common side effects of this drug are:

Minor side effects:
Constipation
Sore throat, nose block, sinus pain
Head pain
Acidity, belching
Joint pain and swelling
Stomach upset
Muscle pain
Sleep trouble
Bowel trouble
Major side effects:
Allergic reaction: itching, swelling or rash on any part of the body
Fever, chills, diarrhea, vomiting, body pain
Weakness, faintness, light headedness
Heartbeats becoming irregular, fast or slow
Weight gain, swelling over ankles and feet, breathlessness with slightest exertion
Chest pain, gasping for breath, wheezing, anxiety, cough with frothy mucus
Confusion
Your blood pressure, liver and kidney functions need to be assessed regularly while you are on this drug

Precautions and Warnings

Pregnancy

Verapamil is not considered ‘safe’ for use during pregnancy. Hence, it should not usually be used during pregnancy because other relatively safer alternatives are available to control the blood pressure level.

Breast Feeding

Whether Verapamil passes into the mother’s milk is not precisely known. Hence, it is preferably avoided during breastfeeding.

Driving

Be cautious as Verapamil may make you feel dizzy or sleepy.

Alcohol

Drinking alcohol can increase the side effects of Verapamil and also lower your blood pressure.

Other General Warnings

Talk to your doctor if

Inform your doctor about your medical history, especially if:
Heart problem (aortic stenosis)
Very low blood pressure
Liver disease
Recent heart attack

Mode of Action

How Does It Work?

Calcium ions are needed for active contraction of smooth muscles in the heart and blood vessels. It inhibits transport of these calcium ions across membranes of heart cells and blood vessels. This inhibits cardiac and vascular smooth muscle contraction, thereby dilating the heart and arteries. Verapamil reduces the load on the heart and decreases tension in blood vessels thus lowering the blood pressure
When used for chest pain, Verapamil dilates the main vessels of the heart. This relaxes the coronary artery and prevents it from going into a spasm. When used for treating irregular heartbeat, it prolongs the time taken for conduction of an electrical stimulus in the AV node of the heart

Interactions

Interactions with other medicines

Aspirin
Digoxin or Digitalis
Other blood pressure and heart medicines
Some antibiotics
Imatinib
Clonidine
HIV/ AIDS medication
Hepatitis C medication
Antifungal medication
Tuberculosis medication
Cholesterol-lowering drugs like Statins
Seizure medication

Interactions with food items

Grapefruit juice and grapefruit should not be consumed by people who are taking Verapamil as these can increase the effects of the medicine and can cause a drastic drop in the blood pressure level.

Dietary Restrictions

If your doctor advised you a low-salt or low-sodium diet, follow these directions carefully.

Dosage

Overdose

An overdose of Verapamil can be fatal. Hence, in case of an overdose, seek emergency care. You will be observed for 48 hours most likely in a hospital set up to check for any immediate or delayed reaction.

Missed a Dose

It is ideal not to miss a dose. Missed dose can be taken when you remember it if there is sufficient time left for the next scheduled dose. Do not compensate for the missed dose by taking an extra dose.

Frequently Asked Questions (FAQs)

Liver diseaseKidney diseaseHeart failureNerve diseases like myasthenia gravis or muscular weaknessLow blood pressure

Store at room temperature. Away from heat, light and moisture. Keep out of reach of children.

Take Verapamil exactly as prescribed by your physician. Do not alter the dosages unless advised. Do not suddenly stop the drug since it can have adverse reactions. Do not chew, crush or break the extended release capsule or pill. Swallow it whole with water.