Verapamil: instructions and references

Verapamil refers to drugs that block calcium channels.

He is able to restore the rhythm of the heartbeat, to treat angina, and also to normalize high blood pressure. Verapamil is able to reduce the amount of oxygen the myocardium needs. This effect is achieved by reducing the contractility of the heart muscle, as well as reducing the frequency of heart beats.

On this page you will find all information about Verapamil: the full instruction on the application for this medicine medium, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already applied Verapamil. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

The calcium channel blocker.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Verapamil cost? The average price in pharmacies is at the level of40 rubles.

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Form of issue and composition

The drug is produced in the form of dragees and film-coated tablets for oral administration, and also in the form of a solution for intravenous administration.

The composition of one tablet of Verapamil includes:

• 40 or 80 mg of verapamil hydrochloride;
• Additional components: methylparaben, calcium phosphate disubstituted, hydroxypropylmethylcellulose, starch, talc purified, titanium dioxide, butylhydroxyanisole, magnesium stearate, gelatin and indigo carmine.

The composition of one dragee Verapamil includes:

• 40 or 80 mg verapamil (in the form of hydrochloride);
• Auxiliary substances: potato starch, lactose, avicel, magnesium stearate, gum arabic, sucrose, gelatin, silicon dioxide, talc, polyvidone K25, paraffin, polyethylene glycol and Chinolingelblack E 104.

The composition of one ampoule (2 ml) of verapamil includes:

• 5 mg verapamil hydrochloride (respectively in 1 ml mg);
• Excipients: citric acid monohydrate, sodium chloride, concentrated hydrochloric acid, sodium hydroxide, injection water.

Pharmacological effect

Acting from the inside to the cell membrane, Verapamil covers the calcium channels and blocks the entry and exit of calcium ions through the membrane complex. The degree of polarization of the membrane plays a leading role in activating the closure of calcium channels. The less polarized the cell membrane, the greater the capacity of the active substance to block the channel.

The sodium channels and one of the types of adrenoreceptors are dependent on Verapamil, but to a lesser extent than the channels of calcium.

Indications for use

Verapamil is indicated for use in the following cases:

1. Treatment of high blood pressure (hypertension).
2. Prophylaxis and treatment of chronic angina pectoris (stress angina, rest stenocardia, vasospastic angina pectoris.)
3. Prevention and therapy of cardiac rhythm disturbances (supraventricular and paroxysmal tachycardia, atrial fibrillation and flutter, supraventricular extrasystole).

Verapamil is indicated for oral administration before or after meals. Scheme of the drug and duration of treatment is determined individually, depending on the severity of the disease, its course, as well as the patient's condition and the effectiveness of therapy.

Contraindications

The use of verapamil is contraindicated for patients with cardiovascular disorders such as:

1. Atrioventricular blockade of II or III degree, except for patients with an artificial pacemaker;
2. Wolff-Parkinson-White syndrome;
3. Sinotrial blockade;
4. Acute myocardial infarction;
5. Pronounced bradycardia;
6. Acute congestive heart failure;
7. Morgagni-Adams-Stokes syndrome;
8. Chronic heart failure;
9. Syndrome of weakness of the sinus node;
10. Cardiogenic shock, if it is not caused by arrhythmia.

You can not take Verapamil:

1. With porphyria;
2. Patients under the age of 18;
3. With increased sensitivity to the main or one of the auxiliary components of the drug;
4. Simultaneously with beta-blockers with intravenous administration;
5. Pregnant and in the period of breastfeeding.

According to the instructions to Verapamil, the category of risk when prescribing the drug includes patients with:

1. Atrioventricular blockade of the 1st degree;
2. Pronounced impairment of liver and kidney function;
3. Arterial hypotension.

Application in pregnancy and lactation

According to the instructions, the use of Verapamil by girls in an "interesting position" is advisable when:

• risk of preterm labor (in combination with other drugs);
• ischemic heart disease;
• placental insufficiency;
• treatment and prevention of arrhythmias;
• nephropathy of pregnant women;
• hypertension (including crisis);
• different types of angina pectoris;
• idiopathic hypertrophic subaortic stenosis;
• hypertrophic cardiomyopathy;
• blocking the side effects of drugs that increase heart rate (for example, Ginipral).

Instructions for use

The instructions for use indicate that Verapamil is taken orally during or after a meal, with a small amount of water. The dosage regimen and duration of treatment are set individually, depending on the patient's condition, severity, the features of the course of the disease and the effectiveness of therapy.

• To prevent attacks of angina pectoris, arrhythmia and in the treatment of hypertension, the drug is prescribed to adults in the initial deesis of 40-80 mg 3 -4 times / day. If necessary, increase the single dose to 120-160 mg. The maximum daily dose of the drug is 480 mg.

In patients with severe hepatic impairment, withdrawal of verapamil from the body is slow, so it is advisable to start treatment with minimal doses. The daily dose of the drug should not exceed 120 mg.

Side effects

Adverse effects of the injectable solution

1. central nervous system: increased fatigue, anxiety, headache, dizziness, fainting, extrapyramidal disorders, retardation, asthenia, depression, drowsiness;
2. Digestive system: nausea, increased activity of hepatic transaminases and alkaline phosphatase;
3. Allergic reactions: facial skin hyperemia, rash, itching, multiforme exudative erythema (including Stevens-Johnson syndrome);
4. The cardiovascular system: pronounced bradycardia (no less than 50 beats per minute), marked decrease in blood pressure, aggravation or development of cardiac insufficiency, tachycardia; possibly - the development of angina pectoris, up to myocardial infarction (especially in patients with severe obstructive lesions of the coronary arteries), arrhythmias (including flutter and fibrillation of the ventricles); with the rapid administration of a solution - asystole, atrioventricular blockade of the III degree, collapse;
5. Other: pulmonary edema, transient loss of vision against the background of maximum concentration, asymptomatic thrombocytopenia, peripheral edema (including swelling of the ankles, legs and feet).

Side effects of tablets:

1. The cardiovascular system: redness of the face, AV blockade, pronounced bradycardia, arterial hypotension, the appearance of symptoms heart failure (with the use of high doses of the drug, especially in predisposed patients);
2. central nervous system: headache, dizziness; in rare cases - inhibition, increased nervous excitability, increased fatigue;
3. Allergic reactions: itching, skin rash;
4. Digestive system: vomiting, nausea, constipation; in some cases - a transient increase in the activity of hepatic transaminases in blood plasma;
5. Other: peripheral edema.

Overdose

Symptoms of a verapamil overdose depend on the dose of the drug taken, the time when the detoxification measures started, and the age of the patient.

• Characteristic symptoms: a significant decrease in blood pressure, violation of the heart rhythm until the shock and cardiac arrest. Dizziness, coma, hypokalemia, hyperglycemia, renal dysfunction of hypoxia, metabolic acidosis, cardiogenic shock with pulmonary edema, convulsions.
• The treatment is aimed at removing the substance from the body and restoring the function of the cardiovascular system. General measures: gastric lavage. General resuscitation measures: indirect cardiac massage, artificial respiration, cardiostimulation, defibrillation. Hemodialysis is not indicated. It is possible to conduct hemofiltration and plasmapheresis.

special instructions

During the drug "Verapamil" should take into account the following:

1. The use of up to 6 g of medication can trigger a loss of consciousness, arterial hypertension, sinus bradycardia, asystole. In such cases, the patient needs symptomatic treatment.
2. All patients need to monitor the functions of the cardiovascular, respiratory systems. It is necessary to monitor the level of glucose and electrolytes in the blood, the volume of excreted urine.
3. Antihypertensive drugs and diuretics increase the antihypertensive effect of the drug.
4. Combination of the drug with inhalation anesthetics, antiarrhythmics, β-adrenoblockers will lead to an increased cardiotoxic effect.
5. Preparations "Lithium" and "Carbamazepine when used simultaneously with the above-mentioned agent, increase the risk of neurotoxic manifestations.
6. Phenobarbital and the drug "Rifampicin" weaken the effectiveness of the drug "Verapamil".
7. When the combination of drugs "Verapamil" and "Digoxin" should monitor the blood content of the last drug. Because the risk is high to provoke an intoxication of the body by him.
8. The active substance is excreted in breast milk. Therefore, it is extremely undesirable to use this remedy during lactation.
9. Pregnant women are prescribed a drug only when the benefit of the medication for the mother is much higher than the risk to the life and health of the baby.
10. The medication used in combination with muscle relaxants can enhance the effects of the latter.
11. Drugs "Ranitidine "Cimetidine" contribute to increasing the concentration of the active substance of the drug "Verapamil" in the blood.
12. The combination of this drug with the drug "Acetylsalicylic acid" can lead to the development of bleeding.

Reviews

We picked up some feedback from people about the drug Verapamil:

1. Hope. I have been taking verapamil for many years. Disruptions of course happen, but much less often than before I started taking this drug. Maybe you need to increase the dose. I take 40 mg 2 times. In the morning and in the evening. Who else uses verapamil, please share your experience.
2. Elena. I take veropamil 2 years 80 mg in the morning and in the evening for lunch 40 mg I add as needed, as prescribed by a doctor. say that something has changed a lot, eh, jumps up to 11, after a pill falls to 9, I'm in shortness of breath. There are interruptions, especially in the evening, my hands are shaking, I have recovered myself. Before, when neither did not take anything, now I feel a little better on the prerogative, I would like it even better.
3. Julia. After the funeral of my father, my mother began to have heart problems, previously only pressure was worried. The doctor immediately said that the lower pressure is elevated - it means cardiac, found tachycardia and cardiac arrhythmia and a few more abnormalities. Heart attacks became more frequent we accept verapamil the second week, mum became much calmer and the heart worries less. The medicine takes according to the doctor's instructions, we observe the sleep and rest regime, I hope that soon the heart will stop worrying at all, verapamil really helps.
4. Alina. After severe stress my mother had high blood pressure, and heart problems started. The hospital showed hypertension and cardiac arrhythmia. To reduce blood pressure and combat arrhythmia, the doctor prescribed a tablet of "Verapamil" to my mother. 1 tab. on, 4 g. After a week of taking the drug, I had to increase the dosage to 8 g per 1 tab. 3 times a day. This dosage was enough for the mother to stop worrying with strange attacks of heartbeats, the pressure ceased to gallop, the headache left. True course after a monthly intake had to continue.

Reviews of doctors and patients with cardiovascular pathologies indicate a positive therapeutic effect, if no side effects are found. Verapamil to a number of patients, in their opinion, saves life after 80 years with discovered problems of heart rhythms.

Analogues

Synonyms of this drug, having the same active substance: Isoptin, Kaveril, Finoptin, Lekoptin.

Verapamil analogs are calcium channel blockers that have a similar effect: Gallopamil, Nifedipine, Nifedipine Retard, Amlodipine, Nicardipine, Riodipine, Nimodipine.

Before using analogues, consult your doctor.

Storage conditions and shelf life

Verapamil is stored out of reach of children, protected from moisture and sunlight, at a temperature of up to 25 ° C. Shelf life is 3 years. Do not take the pill after the expiry date indicated on the package.

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