PAMYLAR 2.5mg/ml Price

Overview

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This medicine contains an important and useful components, as it consists of
Verapamil Hydrochlorideis available in the market in concentration

Name

Verapamil Hydrochloride

Precaution

Patient w/ bradycardia or 1st-degree AV block, attenuated neuromuscular transmission, hypertrophic cardiomyopathy. Avoid abrupt withdrawal. Renal and hepatic impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor BP, heart rate, ECG, LFTs (periodically). Lactation: Distributed in milk; nursing infant doses range from <0.01% to 0.1% of mother’s dose; manufacturer suggests refraining from nursing (though American Academy of Pediatrics committee states that drug is compatible with nursing)

Indication

Essential hypertension, Angina pectoris and prevention of re-infarction, Supraventricular arrhythmias. Paroxysmal supraventricular tachycardias, Atrial fibrillation with rapid ventricular response (except WPWS) , Atrial flutter with rapid conduction, Extrasystoles, Acute hypertension, Acute coronary insufficiency, For the prophylaxis and / or therapy of ectopic arrhythmias (predominantly ventricular extrasystoles) in halothane anaesthesia and in the application of adrenaline in halothane anaesthesia respectively.

Contra indication

Cardiogenic shock, hypotension (systolic pressure <90 mmHg), marked bradycardia, uncompensated heart failure, 2nd- or 3rd-degree AV block (unless pacemaker is fitted), sick-sinus syndrome, severe ventricular dysfunction, atrial flutter or atrial fibrillation and accessory bypass tract (e.g. Wolff-Parkinson-White, Lown-Ganong-Levine syndromes).

Side Effect

>10% Headache,Gingival hyperplasia 1-10% Constipation (9%),Dizziness (4%),Hypotension (4%),Dyspepsia (3%),Nausea (3%),Edema (2%),Rash (2%),Increased liver enzymes (1%),Sleep disturbance (1%),Dyspnea

Pregnancy Category ID

3

Mode of Action

Verapamil inhibits entry of calcium ions into arterial smooth muscle cells as well as the myocytes and conducting tissue. These actions lead to reversal and preventions of coronary artery spasm, reduction in afterload through peripheral vasodilatation and reduction in ventricular rate in patients with chronic atrial flutter or fibrillation and reduction in the occurrence of paroxysmal supraventricular tachycardia. Verapamil reduces BP, relieves angina and slows AV conduction.

Interaction

Increased cardiac depressant effects with beta-blockers and flecainide. Increased risk of additive bradycardia, conduction disturbances and digoxin toxicity with digoxin. Increased risk of bradycardia and hypotension with remifentanil and sufentanil. Increased levels of both everolimus and verapamil on concurrent use. May increase doxorubicin, buspirone, carbamazepine, ciclosporin, epirubicin, eplerenone, quinidine, statins, sirolimus, tacrolimus, quinupristin/dalfopristin levels. Verapamil increase blood alcohol levels. Unpredictable interactions with lithium. Decreased verapamil concentrations with phenobarbital, sulfinpyrazone, rifampicin, rifabutin and rifapentine. Increased verapamil concentrations with protease inhibitors and cimetidine. Potentially Fatal: Increased cardiac depressant effects with amiodarone. Increased risk of QT prolongation with dofetilide, ranolazine, sertindole. Additive bradycardia with ivabradine. Increased risk of heart block with clonidine. Increased risk of acute hyperkalaemia and CV collapse with dantrolene.

Pregnancy Category Note

Information not available

Adult Dose

Child Dose

Renal Dose

Administration