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Verapamil
Verapamil (CALAN / ISOPTIN) is in a class of drugs known as calcium channel blockers. It is used to treat high blood pressure, fast heart beats and to prevent migraine headaches.

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Common uses

Verapamil is used to treat irregular heartbeats (arrhythmias) and high blood pressure. It relaxes your blood vessels so your heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart to control chest pain (angina). If taken regularly, verapamil controls chest pain, but it does not stop chest pain once it starts. Your doctor may give you a different medication to take when you have chest pain.

Before using

Before taking this medication, tell your doctor if you have
- kidney or liver disease;
- other diseases of the heart or blood vessels such as sick sinus syndrome, aortic stenosis, heart failure, heart block, Wolff-Parkinson-White syndrome, coronary artery disease, or low blood pressure; or
- muscular dystrophy.
You may not be able to take verapamil, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above

Directions

This medication should be swallowed whole with a full glass of water unless your doctor directs you otherwise. This medication must be taken as directed to prevent chest pain. It is not effective if taken only when chest pain occurs. Do not stop taking this medication suddenly without your doctor's permission. Chest pain can occur if the medication is stopped too fast. Your dose may need to be gradually decreased.

Cautions

Before using this drug, tell your doctor your medical history, including: allergies (especially drug allergies), heart problems (e.g., heart rhythm disturbances, heart failure), liver or kidney disease, very low blood pressure, muscular dystrophy, brain tumors (cancer). Before heart surgery, tell your doctor you use this medicine. Verapamil prolongs and intensifies the effects of alcohol in your system. Avoid (or very carefully limit) alcoholic beverages while using this medication. Caution is advised when this drug is used in the elderly. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk and a decision should be made whether to stop the drug or avoid breast-feeding. Consult your doctor before breast-feeding.

Possible side effects

This drug may cause dizziness and lightheadedness especially during the first few days. Avoid activities requiring alertness. When you sit or lie down for a while, get up slowly to allow your body to adjust and minimize dizziness. You may also experience weakness, fatigue, nausea, muscle cramps, headache, flushing or constipation. These effects should disappear as your body adjusts to the medication. Inform your doctor if they become bothersome. Notify your doctor immediately if you develop: breathing difficulties, swelling of the hands or feet, irregular heartbeat, fever, stomach/abdominal pain, yellowing eyes and skin, dark urine. If you notice other effects not listed above, contact your doctor or pharmacist.

If you take too much

If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include rapid, slow, or irregular heartbeat; dizziness; fainting; and loss of consciousness.

Additional information

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to verapamil.
Your doctor may ask you to check your pulse (heart rate) daily and will tell you how fast it should be. If your pulse is slower than it should be, call your doctor for directions on taking verapamil that day. Ask your doctor or pharmacist to teach you how to check your pulse.
The extended-release tablet (Covera) does not dissolve in the stomach after being swallowed. It slowly releases medicine as it passes through the small intestines. It is not unusual to see the tablet shell eliminated in the stool.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Drug interactions

Tell your doctor of all prescription and nonprescription drugs you may use, especially of: beta-blockers, intravenous (IV) calcium, cimetidine, cyclosporine, digoxin. Avoid any drugs that increase your heart-rate (the decongestants phenylephrine, pseudoephedrine and phenylpropanolamine are examples). These drugs are commonly found in over-the-counter cough-and-cold products. Do not eat grapefruit or drink grapefruit juice unless your doctor instructs you otherwise. Do not start or stop any medicine without doctor or pharmacist approval.


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