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Verapamil is a calcium channel blocker. It works by relaxing the muscles of your heart and blood vessels.
Verapamil is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders.
Verapamil injection is used to rapidly or temporarily restore normal heartbeats in people with certain heart rhythm disorders.
You should not use verapamil if you have a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker), severe heart failure, Wolff-Parkinson-White, Lown-Ganong-Levine syndrome, or slow heartbeats that have caused you to faint.
You should not use verapamil if you are allergic to it, or if you have a serious heart condition such as:
"sick sinus syndrome" or "AV block" (unless you have a pacemaker);
very low blood pressure; or
if your heart cannot pump blood properly.
You may not be able to use verapamil if you have:
severe congestive heart failure;
certain heart rhythm disorders (such as "Afib," Wolff-Parkinson-White syndrome, Lown-Ganong-Levine syndrome);
a heart condition that causes you to have very rapid heartbeats; or
if you are receiving an intravenous beta-blocker (such as atenolol, metoprolol, or propranolol).
To make sure verapamil is safe for you, tell your doctor if you have ever had:
congestive heart failure;
kidney disease;
liver disease; or
a nerve-muscle disorder such as myasthenia gravis or muscular dystrophy.
It is not known whether verapamil will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breastfeed while using this medicine.
Verapamil oral is not approved for use by anyone younger than 18 years old.
Verapamil injection is given as an infusion into a vein, usually in an emergency situation. A healthcare provider will give you this injection. Your heart rate will be constantly monitored to help determine when your heartbeats have returned to normal.
Oral verapamil is taken by mouth. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Do not use the injection if it looks cloudy or has particles in it. Call your pharmacist for new medicine.
Swallow a capsule or tablet whole and do not crush, chew, break, or open it.
Your blood pressure will need to be checked often. Your liver function may also need to be checked.
If you need surgery, tell the surgeon ahead of time that you take verapamil.
If you have high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.
Store at room temperature away from moisture, heat, and light.
Verapamil injection: Call your doctor for instructions if you miss a dose.
Verapamil oral: Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of verapamil can be fatal.
Drinking alcohol with verapamil can cause side effects.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.
Grapefruit may interact with verapamil and lead to unwanted side effects. Avoid the use of grapefruit products.
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
chest pain, fast or slow heart rate;
a light-headed feeling, like you might pass out;
shortness of breath (even with mild exertion), swelling, rapid weight gain;
fever, upper stomach pain, not feeling well; or
lung problems--anxiety, sweating, pale skin, wheezing, gasping for breath, cough with foamy mucus.
Common side effects may include:
nausea, constipation;
headache, dizziness; or
low blood pressure.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Many drugs can interact with verapamil. Some drugs can raise or lower your blood levels of verapamil, which may cause side effects or make it less effective. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:
aspirin, imatinib, lithium, nefazodone, St. John's wort;
all other heart or blood pressure medicines, especially clonidine, digoxin, flecainide, ivabradine, nicardipine, or quinidine;
an antibiotic - clarithromycin, telithromycin;
antifungal medicine - itraconazole, ketoconazole, posaconazole, voriconazole;
antiviral medicine to treat hepatitis or HIV/AIDS - atazanavir, boceprevir, cobicistat, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir;
a beta blocker - atenolol, carvedilol, labetalol, metoprolol, nadolol, nebivolol, propranolol, sotalol, and others;
cholesterol lowering medicine - atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin;
drugs to treat high blood pressure or a prostate disorder - alfuzosin, doxazosin, prazosin, terazosin, silodosin, tamsulosin;
seizure medicine - carbamazepine, phenobarbital, phenytoin; or
tuberculosis medicine - isoniazid, rifampin.
This list is not complete and many other drugs can interact with verapamil. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Verapamil Hydrochloride (www.drugs.com/verapamil.html).
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:
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
Rare
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
Less common
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
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Verapamil Hydrochloride (www.drugs.com/verapamil.html).
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