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  Verapamil

Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names


Systems Cardiovascular System and Peripheral Vascular System
Category Calcium Channel Blocker


Pharmacokinetics

Given orally, it has a high hepatic metabolism. Hence a higher dose by oral route should be used than by the I.V route. It is highly protein bound.



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Indications

Calcium channel blocking agents are used to relieve and control angina pectoris, to treat hypertension. Hypertension adds to the workload of the heart and arteries. If it continues for a prolonged duration, the heart and arteries may not function effectively. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, cardiac failure, or renal failure. Hypertension may also increase the risk of MI. These problems may be less likely to occur if blood pressure is controlled. Also indicated in cardiac Arrythmias.



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Routes of Administration and Dosage

Short-acting oral dose (tablets): For angina, arrhythmias, hypertension : Adults : 40 to 120 milligrams (mg) three times a day. Children: The usual dose is 4 to 8 mg per kilogram (kg) of body weight a day. For long-acting oral dosage form (extended-release capsules): For hypertension : Adults: 240 to 480 mg once a day. For long-acting oral dosage form (extended-release tablets): For hypertension : Adults : 120 mg once a day to 240 mg every twelve hours. For injection dosage form: For arrhythmias : Adults: 5 to 10 mg slowly injected IV. The dose may be repeated after thirty minutes. Infants up to 1 year of age: 100 to 200 micrograms (mcg) per kg of body weight injected slowly into a vein. The dose may be repeated after thirty minutes. Children 1 to 15 years of age: 100 to 300 mcg per kg of body weight injected slowly into a vein. The dose may be repeated after thirty minutes.



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Contra Indications

It is contraindicated in Hypersensitivity reaction, Acute MI, Hypotension, Lactation and Cardiogenic shock.



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Precautions

Allergies : Allergic reaction to verapamil may occur. Pregnancy: Calcium channel blockers have not been studied in pregnant women. However, studies in animals have shown that large doses of calcium channel blockers cause birth defects, prolonged pregnancy, poor bone development, and stillbirth. Breast-feeding : Verapamil passes into breast milk, but it has not been reported to cause problems in nursing babies. Older adults: Elderly people may be especially sensitive to the effects of calcium channel blockers. This may increase the chance of adverse effects during treatment.



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Interactions

Interaction with the following drugs have been reported: Acetazolamide, Amphotericin B, Corticosteroids, Dichlorphenamide, Diuretics, Methazolamide, Beta-blockers like acebutolol, atenolol, betaxolol, carteolol, labetalol, metoprolol, nadolol, oxprenolol, penbutolol, pindolol, propranolol, sotalol, timolol: Effects of both the drugs may be increased. In addition, adverse effects may occur if a calcium channel blocker or a beta-blocker is stopped suddenly after use together. Carbamazepine, Cyclosporine, Procainamide,Quinidine: Effects of these drugs may be increased if they are used with calcium channel blockers. Digitalis glycosides : Effects of these drugs may be increased if they are used with calcium channel blockers. Disopyramide : Effects of calcium channel blockers on the heart may be potentiated.



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Brand Names

Calaptin (Boehringer Mannheim ), Vasopten (Torrent).



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Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names

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