Verapamil Hydrochloride: Uses, Dosage, Side Effects | MedexInfo

Verapamil Hydrochloride

Rx

Generic NameVerapamil Hydrochloride

Therapeutic ClassCalcium Channel Blocker

Max / 24h480 mg orally, 20 mg IV

Common Dose80–120 mg orally 3 times daily (immediate release); 180–480 mg daily (sustained release)

PregnancyUse only if benefit outweighs risk (Category C)

Indications ▼

Hypertension

Angina pectoris (chronic stable, vasospastic, unstable)

Supraventricular tachyarrhythmias (atrial fibrillation/flutter, paroxysmal supraventricular tachycardia)

Migraine prophylaxis

Mechanism & Pharmacokinetics ▼

Mechanism: Inhibits calcium ion influx into vascular smooth muscle and myocardial cells, leading to vasodilation, decreased heart rate, and reduced myocardial contractility.

Pharmacokinetics: Well absorbed orally; undergoes extensive first-pass metabolism in liver. Peak plasma concentration 1–2 hours (immediate release). Protein binding 90–95%. Metabolized hepatically, excreted in urine and bile.

Dosage & Administration ▼

Condition	Recommended Dose	Frequency
Hypertension	80–120 mg	3 times daily (immediate release); 180–480 mg once daily (sustained release)
Angina pectoris	80–120 mg	3 times daily (immediate release); 180–360 mg once daily (sustained release)
Supraventricular tachyarrhythmias	IV 2.5–5 mg	Slow IV over 2 minutes, repeat if necessary
Migraine prophylaxis	120–240 mg	Once daily (sustained release)

Note: Adjust dose according to clinical response and renal/hepatic function. Avoid rapid IV injection.

Side Effects ▼

Bradycardia, hypotension

Constipation, dizziness, headache

Peripheral edema

Rare: AV block, heart failure exacerbation, hepatic enzyme elevation

Contraindications ▼

Severe hypotension

2nd or 3rd degree AV block without pacemaker

Severe left ventricular dysfunction

Hypersensitivity to verapamil

Drug Interaction ▼

Beta-blockers: additive bradycardia or AV block

Digoxin: increased risk of AV block

Carbamazepine, phenytoin: may reduce verapamil levels

CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): increase verapamil levels

Pregnancy & Lactation ▼

Use only if benefit outweighs risk (Category C)

Excretion in breast milk occurs; monitor infant for bradycardia

Clinical / Research Summary ▼

Therapeutic Role: Effective calcium channel blocker for management of hypertension, angina, and certain arrhythmias.

Clinical Effectiveness: Reduces blood pressure, prevents angina attacks, controls supraventricular tachyarrhythmias.

Safety Profile: Generally well tolerated; monitor heart rate and blood pressure. Watch for constipation and peripheral edema.

Current Research: Studies evaluating efficacy in migraine prevention and combination therapy with other antihypertensives.

Patient Counseling Points ▼

Take oral tablets with or without food consistently

Do not abruptly stop therapy

Report dizziness, slow heartbeat, or swelling of legs

Inform physician about all other medications

Storage & Handling ▼

Store at room temperature, protect from light and moisture

Keep out of reach of children

Brand Names (Bangladesh & Global) ▼

Bangladesh (Local Brands):

Veracal Isoptin Verapamil

Global / International Brands:

Isoptin Verelan Calan

Medical Disclaimer: This information is intended for educational purposes only and must not replace professional medical advice.

Reference Hubs:

• Drug Class: Calcium Channel Blockers • Conditions: Hypertension • Conditions: Angina