Verapamil Hydrochloride

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Generic Name of Verapamil Hydrochloride - Learn More

Verapamil Hydrochloride

Verapamil Hydrochloride Precaution - What You Need to Know

Before starting Verapamil Hydrochloride, patients should consult their healthcare provider due to the following precautions:

- Cardiovascular Conditions: Verapamil is a calcium channel blocker that should be used with caution in patients with heart failure, bradycardia, hypotension, or sick sinus syndrome. Patients with a history of these conditions may require close monitoring during treatment, as Verapamil can exacerbate these issues by slowing the heart rate and lowering blood pressure.
- Liver and Kidney Function: Verapamil is metabolized by the liver and excreted via the kidneys, so dosage adjustments may be necessary in patients with hepatic or renal impairment to avoid accumulation and potential toxicity.
- Concomitant Medications: Verapamil interacts with a variety of drugs. For example, combining it with beta-blockers, digoxin, or other drugs that slow the heart rate can cause excessive bradycardia or heart block. Caution should be taken when combining Verapamil with other medications, and regular monitoring may be necessary.
- Alcohol Consumption: Alcohol can increase the effects of Verapamil, leading to excessive lowering of blood pressure and increased risk of dizziness and fainting. Patients should limit or avoid alcohol while taking Verapamil.
- Pregnancy and Breastfeeding: Verapamil should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as there are concerns about its effects on fetal development. Verapamil can also pass into breast milk, so its use during breastfeeding should be discussed with a healthcare provider.

Verapamil Hydrochloride Indication - Uses and Benefits

Verapamil is prescribed for various cardiovascular and other health conditions, including:

- Hypertension (High Blood Pressure): Verapamil is used as an antihypertensive medication to manage high blood pressure. By relaxing the blood vessels, it helps to reduce the workload on the heart and lowers blood pressure.
- Angina (Chest Pain): Verapamil is prescribed for the treatment of angina, particularly prinzmetal angina or stable angina, by improving blood flow to the heart and reducing chest pain.
- Arrhythmias (Irregular Heartbeats): Verapamil is commonly used to treat supraventricular tachycardia (SVT), including atrial fibrillation or atrial flutter, as it helps to slow the heart rate by blocking calcium channels and decreasing electrical conduction in the heart.
- Migraine Prophylaxis: Verapamil can also be prescribed off-label for the prevention of migraines, particularly in patients who experience frequent or severe migraines.
- Prevention of Paroxysmal Supraventricular Tachycardia (PSVT): Verapamil is used to prevent or treat PSVT, a condition characterized by abnormally rapid heartbeats originating in the upper chambers of the heart.

Verapamil Hydrochloride Contraindications - Important Warnings

Verapamil should not be used in the following situations:

- Severe Heart Block: Verapamil is contraindicated in patients with a second- or third-degree heart block (unless they have a pacemaker), as it can further impair heart conduction and lead to severe bradycardia.
- Severe Left Ventricular Dysfunction: Verapamil should not be used in patients with severe left ventricular dysfunction, as it can worsen heart failure by reducing the heart’s ability to pump blood effectively.
- Hypotension: Verapamil should not be used in patients with severely low blood pressure (hypotension), as it can further lower blood pressure and increase the risk of dizziness, fainting, and shock.
- Allergic Reactions: Verapamil is contraindicated in patients who are hypersensitive to Verapamil Hydrochloride or other calcium channel blockers.
- Pregnancy Category C: It is not recommended for use during pregnancy unless absolutely necessary, as it has been shown to cross the placenta.

Verapamil Hydrochloride Side Effects - What to Expect

Common and severe side effects of Verapamil Hydrochloride include:

- Common Side Effects:
- Constipation: A frequent side effect, particularly in elderly patients.
- Dizziness and Lightheadedness: Especially when standing up quickly, due to its blood pressure-lowering effects.
- Headache: Some patients report headaches as a side effect of Verapamil.
- Nausea and vomiting: Mild gastrointestinal discomfort can occur.
- Bradycardia (Slow Heart Rate): Can occur as Verapamil works by slowing down the heart’s electrical conduction.
- Edema (Swelling): Swelling in the ankles or feet can be a side effect, especially with prolonged use.

- Severe Side Effects:
- Severe Bradycardia: Excessively slow heart rate that can lead to syncope (fainting) and other complications.
- Heart Block: Can cause or worsen heart block, especially in patients with pre-existing conduction system problems.
- Hypotension (Low Blood Pressure): Excessive lowering of blood pressure can result in dizziness, fainting, or shock.
- Liver Dysfunction: Liver enzymes may rise, indicating possible liver toxicity.
- Severe Allergic Reactions: Rash, itching, and swelling can occur in rare cases.

Verapamil Hydrochloride Pregnancy Category ID - Safety Information

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Verapamil Hydrochloride Mode of Action - How It Works

Verapamil is a calcium channel blocker that works by inhibiting the influx of calcium ions into the smooth muscle and myocardial cells, primarily in the heart and blood vessels. By blocking calcium channels, it reduces:

- Cardiac Contractility: Verapamil decreases the force with which the heart muscle contracts, leading to a reduction in heart rate and lower blood pressure.
- Vascular Tone: By relaxing smooth muscle in the blood vessels, Verapamil promotes vasodilation (widening of blood vessels), further lowering blood pressure and improving blood flow.
- Conduction of Electrical Impulses: Verapamil slows the conduction of electrical impulses through the heart's conduction system, which is beneficial in treating arrhythmias like atrial fibrillation and supraventricular tachycardia.

Verapamil Hydrochloride Drug Interactions - What to Avoid

Verapamil may interact with several drugs, altering its effectiveness or leading to dangerous side effects. Notable interactions include:

- Beta-Blockers: Concurrent use with beta-blockers (e.g., atenolol, metoprolol) can enhance the risk of heart block, severe bradycardia, and hypotension.
- Digoxin: Verapamil can increase blood levels of digoxin, leading to digoxin toxicity, which may manifest as nausea, vomiting, visual disturbances, and arrhythmias.
- CYP3A4 Inhibitors: Verapamil is metabolized by the CYP3A4 enzyme, so drugs that inhibit this enzyme, such as erythromycin, ketoconazole, and grapefruit juice, can increase the levels of Verapamil, potentially leading to side effects like hypotension and bradycardia.
- Statins: Verapamil can increase the blood concentration of statins (e.g., simvastatin), leading to an increased risk of muscle toxicity or rhabdomyolysis.
- Other Calcium Channel Blockers: Using Verapamil with other calcium channel blockers (e.g., diltiazem) can enhance the effects of both drugs, resulting in excessive lowering of blood pressure and risk of bradycardia.
- Antihypertensives: Verapamil can have an additive effect when used with other antihypertensive agents (e.g., ACE inhibitors, diuretics), further lowering blood pressure.

Verapamil Hydrochloride Adult Dose - Recommended Dosage

The recommended dose for adults depends on the condition being treated:

- Hypertension:
- Starting dose: 80-120 mg taken orally once or twice daily.
- Maintenance dose: 240-480 mg daily, divided into 2 or 3 doses. The maximum recommended dose is 480 mg/day.

- Angina:
- Starting dose: 80-120 mg taken orally, 3 times a day.
- Maintenance dose: 240-480 mg daily.

- Arrhythmias (e.g., SVT):
- Loading dose: 5-10 mg intravenously over 2 minutes, followed by a maintenance infusion of 0.005-0.01 mg/kg/min.
- Oral therapy: The maintenance dose is typically 180-480 mg daily, depending on the patient’s response.

Verapamil Hydrochloride Child Dose - Dosage for Children

Verapamil is not typically prescribed for children under 18 years old unless under specialist care. For pediatric patients with specific conditions (e.g., supraventricular tachycardia), the dose may be:

- Starting dose: 0.1-0.3 mg/kg every 6-8 hours.
- Maintenance dose: This is adjusted according to the child’s age, weight, and response to the medication. Regular monitoring is crucial.

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Always consult your healthcare provider before taking Verapamil Hydrochloride to ensure the medication is appropriate for your condition and that you are receiving the correct dose.

Verapamil Hydrochloride Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, the dose of Verapamil should be reduced. Specifically:

- For patients with mild to moderate renal impairment, a lower starting dose is recommended, typically at the lower end of the dosing range.
- In cases of severe renal impairment, Verapamil should be used with caution and careful monitoring for side effects. Dosing adjustments are made based on the patient's response and kidney function.