Verapamil Drug uses, Generic/Brand Names, Category, Indications, Dosage, Mechanism of Action, Side Effects, Precautions

Verapamil1

Verapamil Drug uses, Generic/Brand Names, Category, Indications, Dosage, Mechanism of Action, Side Effects, Precautions,

Generic Name: Verapamil

Brand Names: Calaptin, Celovera, Vasopten, Veramil.

Category / Class: Anti-anginal drugs/ Calcium channel blockers.

Indications:

Chronic coronary insufficiency, angina pectoris, coronary spasms vasospastic angina, angina after M.I, hypertension.

Tachycardias such asparoxysmal supraventricu- lar tachycardia, atrial fibrillation/flutter with tachyarrhythmia, premature beats.

Verapamil Uses:

The antihypertensive effect of verapamil, stems from a decrease in peripheral vascular resistance without an increase in heart rate as a reflex response.

lt has a marked antiarrhythmic effect, particularly in supraventricular arrhythmia’s. It delays impulse conduction in the A.V. node.

Due to Ca-antagonistic effect on the smooth vascular muscles of the coronaries, verapamil enhances myocardial blood flow, even in poststenotic areas, and relieves coronary spasms which con- tributes to its anti-ischaemic & anti- anginal efficacy in all types of coronary artery diseases.

Dosage:

(*OD= Once a Day*)

(* BD= Twice a day/ 2 Times a day*)

(*TD= 3 Times a day*)

Adults Doses:

Hypertension uses doses:

Extended release capsules

Initial dose:

200 mg oral OD

initial doses of 100 mg oral OD at bedtime (e.g. low-weight patients)

Maintenance dose:

Maximum dose: 400 mg/day

Extended release tablets:

Initial dose:

180 mg oral OD at bedtime

Maintenance dose:

Maximum dose: 480 mg/day

Immediate release tablets

Initial dose:

80 mg oral 3 times a day;

Alternatively, 40 mg oral 3 times a day

Maintenance dose:

Maximum dose: 480 mg/day

Sustained release capsules

Initial dose:

240 mg oral OD morning

Alternatively, 120 mg oral OD morning

Maintenance dose:

Maximum dose: 480 mg/day

Sustained release tablets

Initial dose:

180 mg oral OD morning with food:

Alternatively, 120 mg oral OD morning with food

Maintenance dose:

Maximum dose: 480 mg/day

Supraventricular Tachycardia Uses Adult Dose

Parenteral

Initial dose:

5-10 mg IV bolus over at least 2 minutes

Repeat dose: 10-30 minutes after the initial dose if the response is inadequate

Angina Pectoris Uses Adult Dose

Extended release tablets:

Initial dose:

180 mg oral OD at bedtime

Maximum dose: 480 mg/day

Immediate release tablets:

Initial dose:

80 to 120 mg oral 3 times a day

Alternatively, 40 mg oral 3 times a day

Maintenance dose:

Maximum dose: 480 mg/day

Arrhythmias Uses Adult Dose:

Immediate release tablets:

Chronic atrial fibrillation in digitalized patients: 240 to 320 mg/day oral in 3 or 4 divided doses

Prophylaxis of paroxysmal supraventricular tachycardia (PSVT) in non-digitalized patients: 240 to 480 mg/day oral in 3 or 4 divided doses

Geriatric Doses:

Hypertension uses Geriatric Doses:

Extended release capsules:

Initial dose:

100 mg oral OD at bedtime

Maintenance dose:

Maximum dose: 400 mg/day

Immediate release tablets:

Recommended initial dose: 40 mg oral 3 times a day

Maintenance dose

Maximum dose: 480 mg/day

Sustained release capsules:

Initial dose: 120 mg oral OD morning

Maintenance dose:

Maximum dose: 480 mg/day

Sustained release tablets:

Initial dose:

120 mg oral OD morning with food

Maintenance dose:

Maximum dose: 480 mg/day

Angina Pectoris Uses Geriatric Dose:

Immediate release tablets:

Initial dose:

40 mg oral 3 times a day

Maintenance dose:

Maximum dose: 480 mg/day

Pediatric Doses:

Supraventricular Tachycardia uses Pediatric Doses

Parenteral:
Less than 1 year:

Initial dose: 0.1 to 0.2 mg/kg  IV bolus over at least 2 minutes

Repeat dose: 0.1 to 0.2 mg/kg  IV 30 minutes after the initial dose if the response is inadequate

1 to 15 years:

Initial dose: 0.1 to 0.3 mg/kg IV bolus over at least 2 minutes

Maximum initial dose: 5 mg

Repeat dose: 0.1 to 0.3 mg/kg IV 30 minutes after the initial dose if the response is inadequate

Maximum repeat dose: 10 mg.

Route of Administration:-

May be taken with or without food- Oral, IV

Frequency:-

Once a day (OD), twice a day / 2 Times a day (BD), 3 Times a day (TD)

Contra-indications:

Cardiovascular shock, acute M.I. (bradycardia, hypotension, L.V.F.), severe conduction disorders (2nd & 3rd degree A V block, sinoatrial block) sick sinus syndrome.

Special Precautions:

Capability to drive or operate machinery may be impaired. Hepatic or renal impairment.

Pregnancy &Lactation:

Pregnancy Category C

Drug passes into the breast milk ,not recommended.

Adverse Drug Reaction’s (ADR’s):-

Constipation, gingival hyperplasia, AV block, flu-like syndrome, flushing, increased liver enzymes, peripheral edema, pulmonary edema.

Side-effects:

Constipation, dizziness, headache, flushing, fatigue, nervousness, ankle oedemas, erythromelalgia and paresthesia.

Mechanism of Action:-

Verapamil hydrochloride is a slow channel blocker. Its hypertensive effect is attributed to the reduction of systemic vascular resistance and selective vasodilation of peripheral arteries. Its anti-anginal effect is related to inhibition of coronary spasm and relaxation of main coronary artery and coronary arterioles.

General Considerations:

Advise patient to take with food or milk.

Warn patient to not to drink alcohol while taking this drug.

Avoid activities requiring mental alertness or coordination.

Advise against sudden discontinuation of the drug.

Monitoring Parameters:

BP, heart rate, ECG.

Liver and renal function.

Conclusion:-

If you have any questions and complaints and more information for consult your “Family Doctor” or “Personal “Doctor”.

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