Commonly reported side effects of verapamil include: sinus bradycardia. Other side effects include: pulmonary edema, severe hypotension, and second degree atrioventricular block. See below for a comprehensive list of adverse effects.

Applies to verapamil: oral capsule extended release, oral tablet, oral tablet extended release

Other dosage forms:

• intravenous solution

Along with its needed effects, verapamil may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking verapamil:

Less common

• Blue lips and fingernails
• blurred vision
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• chest pain
• confusion
• coughing that sometimes produces a pink frothy sputum
• difficult, fast, noisy breathing, sometimes with wheezing
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• increased sweating
• lightheadedness, dizziness, or fainting
• pale skin
• shortness of breath
• slow or irregular heartbeat
• sore throat
• sweating
• swelling in legs and ankles
• unusual tiredness or weakness

Rare

• Chills
• cold sweats
• feeling of warmth
• redness of the face, neck, arms and occasionally, upper chest

Some side effects of verapamil may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Difficulty having a bowel movement (stool)
• headache

Less common

• Acid or sour stomach
• belching
• difficulty in moving
• heartburn
• indigestion
• joint pain
• muscle aching or cramping
• muscle pains or stiffness
• nausea
• rash
• stomach discomfort, upset, or pain
• trouble sleeping
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
• swollen joints

Applies to verapamil: compounding powder, intravenous solution, oral capsule extended release, oral tablet, oral tablet extended release

The most commonly reported side effects include constipation, dizziness, and headache.

Seizures occurred rarely with IV administration.

Paralysis/tetraparesis was reported in a patient taking this drug and colchicine concurrently.

Very common (10% or more): Headache (up to 12.1%)

Common (1% to 10%): Dizziness, lethargy

Rare (0.01% to 0.1%): Seizures

Frequency not reported: Rotary nystagmus, sleepiness, vertigo, lightheadedness, tingling, numbness, neuropathy

Postmarketing reports: Syncope, cerebrovascular accident, equilibrium disorders, parkinsonism/extrapyramidal symptoms/syndrome, paresthesia, shakiness/tremor, paralysis/tetraparesis, somnolence

Cardiovascular side effects may occur with greater intensity at higher doses or in patients with a history of myocardial damage.

Approximately 15% of patients who had atrial flutter/fibrillation and received this drug and digoxin developed resting ventricular rates below 50 beats/min; in the same trial, asymptomatic hypotension occurred in approximately 5% of patients.

Asystole occurred after second/third degree AV block and was usually short in duration, with spontaneous cardiac action returning within seconds in the form of a sinus rhythm.

Common (1% to 10%): Symptomatic hypotension/hypotension/abrupt blood pressure fall, sinus bradycardia/bradycardia (heart rate less than 50 beats/minute), severe tachycardia, ankle edema/edema, development/aggravation of congestive heart failure (CHF), atrioventricular (AV) block, peripheral edema

Uncommon (0.1% to 1%): Second-/third-degree AV block, palpitations, orthostasis

Postmarketing reports: Angina pectoris/chest pain, AV dissociation, ECG abnormal, claudication, hypertension, myocardial infarction, sinus arrest with asystole, decreased myocardial contractility, cardiogenic shock, bradyarrhythmia in atrial fibrillation, vasculitis, erythromelalgia

Non-obstructive paralytic ileus was reversible when treatment was stopped.

Gingival hyperplasia occurred when this drug was given over a prolonged period of time, and was reversible once the drug was discontinued.

Common (1% to 10%): Constipation, dyspepsia, nausea, diarrhea, flatulence

Uncommon (0.1% to 1%): Abdominal discomfort/pain

Frequency not reported: Non-obstructive paralytic ileus/ileus, bloating

Postmarketing reports: Dry mouth, gastrointestinal stress, gingival hyperplasia, vomiting

Bronchospasm and laryngeal spasm occurred during hypersensitivity reactions.

Common (1% to 10%): Pulmonary edema, pharyngitis, sinusitis, rhinitis, dyspnea

Rare (0.01% to 0.1%): Broncho/laryngeal spasm

Common (1% to 10%): Fatigue, tiredness/malaise, accidental injury, pain

Frequency not reported: Infection, flu syndrome

Postmarketing reports: Tinnitus, asthenia

Common (1% to 10%): Scalp irritation, rash

Uncommon (0.1% to 1%): Itching, urticaria, flushing, exanthema

Frequency not reported: Diaphoresis, photodermatitis

Postmarketing reports: Ecchymosis, bruising, alopecia/hair loss, hyperkeratosis, macules, Stevens-Johnson syndrome, hyperhidrosis/sweating, erythema multiforme, Quincke's edema/angioneurotic edema

Itch and urticaria occurred in hypersensitivity reactions.

Common (1% to 10%): Sleep disturbance

Uncommon (0.1% to 1%): Bad dreams, depression/emotional depression

Postmarketing reports: Confusion, psychotic symptoms, insomnia, nervousness

Common (1% to 10%): Myalgia

Frequency not reported: Muscle fatigue

Postmarketing reports: Muscle cramps, arthralgia

Reversible elevations liver enzymes occurred during treatment, and are likely the result of a hypersensitivity reaction (e.g., allergic hepatitis).

Uncommon (0.1% to 1%): Elevated liver enzymes (transaminases, alkaline phosphatase)

Rare (0.01% to 0.1%): Hypersensitivity/allergic reactions

Postmarketing reports: Allergy aggravated

Frequency not reported: Lowered glucose tolerance

Postmarketing reports: Hyperkalemia

Postmarketing reports: Galactorrhea, increased blood prolactin/hyperprolactinemia, increased urination, spotty menstruation, erectile dysfunction/impotence

Postmarketing reports: Renal failure

Gynecomastia occurred in older male patients on prolonged treatment, and was reversible upon discontinuation of this drug.

Postmarketing reports: Gynecomastia

Postmarketing reports: Purpura

Postmarketing reports: Blurred vision