Verapamil

How it works

     * Verapamil affects the passage of calcium ions across cell membranes
       of smooth muscle cells and heart (myocardial) cells.
     * When used to treat angina, verapamil dilates the main coronary
       blood vessels and reduces how much energy and oxygen the heart uses
       to beat.
     * When used to treat arrhythmias such as Atrial Fibrillation,
       verapamil prolongs the refractory period (the period of time
       immediately following electrical stimulation of the AV node) and
       slows the heart rate.
     * Verapamil can also lower blood pressure.
     * Verapamil belongs to the class of drugs known as calcium channel
       blockers.

Upsides

     * May be used as an ongoing treatment to relieve symptoms such as
       chest pain in people with unstable or chronic stable angina, or
       angina due to coronary artery spasm. Will not relieve acute
       episodes of angina (other medications such as sublingual
       nitroglycerin are used for this purpose).
     * May be used to treat certain arrhythmias such as atrial
       fibrillation, atrial flutter, and repetitive paroxysmal
       supraventricular tachycardia.
     * May be used for the treatment of high blood pressure
       (hypertension), alone or in combination with other agents for high
       blood pressure.
     * Available as immediate-release tablets, extended/sustained-release
       tablets and capsules, and in an injectable form.
     * Generic verapamil is available.

Downsides

   If you are between the ages of 18 and 60, take no other medication or
   have no other medical conditions, side effects you are more likely to
   experience include:
     * Constipation, dizziness, headache, facial flushing, nausea, low
       blood pressure, edema, elevated liver enzymes, sexual dysfunction,
       and shortness of breath. May also cause cold-like symptoms such as
       a stuffy nose, sinus pain, and sore throat.
     * May interact with a number of different medications including some
       anti-infectives, tuberculosis medications, other drugs to manage
       blood pressure or arrhythmias, statins, and grapefruit products.
     * May not be suitable for some people including those with certain
       preexisting heart conditions including severe heart failure and
       hypotension. People with kidney or liver disease may need extra
       monitoring.
     * Verapamil is not FDA approved for people younger than 18 years.

   Notes: In general, seniors or children, people with certain medical
   conditions (such as liver or kidney problems, heart disease, diabetes,
   seizures) or people who take other medications are more at risk of
   developing a wider range of side effects. For a complete list of all
   side effects, [84]click here.

Bottom Line

   Verapamil can help regulate the heart rate and lower blood pressure and
   is used to treat certain heart conditions. Constipation is the most
   common side effect of verapamil and it may interact with a number of
   different medicines and grapefruit products.

Tips

     * Do not crush, break or chew extended or sustained-release verapamil
       tablets or capsules; swallow whole. Some extended-release capsules
       may be able to be opened and the contents sprinkled on applesauce
       then swallowed straight away. Ask your doctor about this if you
       have difficulty swallowing capsules.
     * The dosage of verapamil varies among individuals depending on age,
       the condition being treated and the presence of other medical
       conditions. Your doctor will tailor your dosage to suit you.
     * Avoid grapefruit and grapefruit juice products.
     * People taking verapamil to lower high blood pressure should also
       make lifestyle changes including managing high blood pressure and
       high cholesterol, losing weight if they are overweight, stopping
       smoking if they smoke and partaking in exercise as per a doctor's
       recommendations.
     * If verapamil makes you dizzy this may affect your ability to drive
       or operate machinery. Avoid doing these activities if verapamil has
       this effect on you.
     * Verapamil may make you feel dizzy when going from a lying or
       sitting position to standing, increasing your risk of falls. Stand
       slowly and remove any fall hazards from your home such as loose
       rugs.
     * Avoid or limit alcohol intake while taking verapamil because it may
       further lower your blood pressure or increase the likelihood of
       dizziness.
     * Call your doctor if you experience shortness of breath, a change in
       your heartbeat, light-headedness, anxiety-like feelings, loss of
       appetite, yellowing of the skin or eyes, or flu symptoms while
       taking verapamil.
     * Although verapamil works on calcium ions, it does not alter calcium
       levels in your blood; although high levels of blood calcium could
       possibly affect the way verapamil works.
     * Your doctor will need to monitor your blood pressure, liver and
       kidney function regularly while you are taking verapamil.
     * Do not take any other medication, including that brought
       over-the-counter, without first checking with your doctor or
       pharmacist that it is compatible with verapamil.

Response and Effectiveness

     * Peak levels of verapamil are reached one to two hours after oral
       administration. Peak levels may be increased in people with liver
       disease or of an older age.

References

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