Verapamil Oral

Uses

Verapamil is used with or without other medications to treat high blood pressure (hypertension), chest pain (angina) and certain types of irregular heartbeat. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. When used regularly, verapamil can decrease the number and severity of episodes of chest pain from angina. It can also control your heart rate if you have a fast/irregular heartbeat. Verapamil is called a calcium channel blocker. It works to control blood pressure by relaxing blood vessels so blood can flow more easily, helping the heart work less hard to pump blood through your body. This effect, along with the relaxation of narrowed heart blood vessels, may also relieve the symptoms of angina. Verapamil also lowers a fast/irregular heartbeat, making you more comfortable and better able to participate in daily activities.

OTHER USES:
This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used to treat another type of heart disease (hypertrophic cardiomyopathy).

How to use Verapamil Oral

Take this medication by mouth with or without food, usually three times daily or as directed by your doctor. Swallow the tablet whole. Do not crush or chew the tablet.

Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit juice can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.

The dosage is based on your age, medical condition, body size and response to therapy. If you are older or have severe liver problems, your dosage may need to be adjusted.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. For the treatment of high blood pressure, it may take up to a week before the full benefit of this drug takes effect. If used for angina, this medication must be taken regularly to be effective. It should not be used to treat angina when it occurs. Use other medications (e.g., sublingual nitroglycerin) to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details.

Do not suddenly stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.

Inform your doctor if your condition worsens (e.g., your routine blood pressure readings increase).

Before taking verapamil, tell your doctor or pharmacist if you are allergic to it; or to other calcium channel blockers (e.g., diltiazem, nifedipine); or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: very low blood pressure, certain heart problems (e.g., second- or third-degree atrioventricular block, sick sinus syndrome without a pacemaker, Wolff-Parkinson-White syndrome, Lown-Ganong-Levine syndrome), severe heart failure.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, brain tumors, a certain type of heart disease (hypertrophic cardiomyopathy), mild to moderate heart failure, neuromuscular problems (e.g., muscular dystrophy, myasthenia gravis).

This drug may make you dizzy; use caution engaging in activities requiring alertness such as driving or using machinery.

Verapamil prolongs and intensifies the effects of alcohol in your system. Limit alcoholic beverages while using this medication.

Before having surgery, tell your doctor or dentist that you are taking this medication.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Though there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.

Overdose

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: severe dizziness/fainting, fast/irregular/very slow heartbeat, confusion.

NOTES:

Do not share this medication with others.

Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Laboratory and/or medical tests (e.g., liver function tests, heart exam, blood pressure, electrocardiograms) may be performed from time to time in order to monitor your progress or check for side effects. Consult your doctor for more details.

There are different brands and types of this medication available. Many do not have the same effects. Do not change brands or types without consulting your doctor or pharmacist.

Have your blood pressure checked regularly while taking this medication. Discuss with your doctor how to monitor your own blood pressure.

MISSED DOSE:

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE:

Store at room temperature at 59-77 degrees F (15-25 degrees C) away from sunlight and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT:
Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).

Dizziness, nausea, headache, fatigue and constipation may occur as your body adjusts to the medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.

To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated while using this drug, consult your pharmacist for help in selecting a stool softener.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: swelling of the ankles/feet, shortness of breath, persistent fatigue, fast/irregular/very slow heartbeat, unusual dreams, mental/mood changes, decreased sexual ability/desire, fainting.

Tell your doctor immediately if any of these rare but very serious side effects occur: severe abdominal pain, dark urine, severe nausea/vomiting, severe constipation, yellowing of the eyes/skin, sudden dizziness/fainting, severe/persistent nausea, seizures.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

See also the How to Use section.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious interactions may occur: certain anti-arrhythmic drugs (e.g., disopyramide, dofetilide), ranolazine.

If you are currently using any of these medications, tell your doctor or pharmacist before starting verapamil.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: inhaled anesthetics (e.g., halothane), aspirin, colchicine, beta blockers (e.g., metoprolol, propranolol, timolol), alpha blocking medications (e.g., prazosin), intravenous calcium, certain anti-cancer drugs (e.g., adriamycin, cisplatin, cyclophosphamide, doxorubicin, paclitaxel, procarbazine, vincristine, vindesine), corticosteroids when given with anti-cancer drugs (e.g., prednisone), digoxin, flecainide, lithium, certain neuromuscular blocking drugs (e.g., vecuronium, succinylcholine), drugs that affect how your body gets rid of verapamil (azole antifungals including itraconazole, barbiturates including phenobarbital, cimetidine, rifamycins including rifabutin and rifampin, St. John's wort).

Verapamil also may affect how your body gets rid of some drugs (e.g., cyclosporine, sirolimus, tacrolimus, eplerenone, erythromycin, quinidine, midazolam, triazolam, tizanidine, statins including simvastatin, certain anti-seizure drugs including carbamazepine).

Check the labels on all your medicines (e.g., cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs - NSAIDs for pain/fever reduction) because they may contain ingredients that could increase your blood pressure or heart rate (e.g., pseudoephedrine, phenylephrine, chlorpheniramine, diphenhydramine, clemastine, ibuprofen, naproxen). Ask your pharmacist about the safe use of those products.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.