Angil
Tablet
Medimet Pharmaceuticals Ltd.Generic:
Verapamil HydrochlorideWeight:
80 mgbest Price:
? 4.25Generic
Verapamil Hydrochloride
Indications
Verapamil Tablet: Essential hypertension Angina pectoris and prevention of re-infarction Supraventricular arrhythmias Verapamil Injection: Tachycardias such as: Paroxysmal supraventricular tachycardias Atrial fibrillation with rapid ventricular response (except WPWS) Atrial flutter with rapid conduction Extrasystoles Acute hypertension Acute coronary insufficiency For the prophylaxis and / or therapy of ectopic arrhythmias (predominantly ventricular extrasystoles) in halothane anaesthesia and in the application of adrenaline in halothane anaesthesia respectively.
Pharmacology
Verapamil is a calcium ion influx inhibitor that inhibits the inward movement of calcium into cardiomyocytes, smooth muscle cells and His-Purkingi system. The tablets are designed for sustained release of the drug in the intestine.
Dosage Administration
Verapamil is an L-type calcium channel blocker with antiarrhythmic, antianginal, and antihypertensive activity. Immediate-release verapamil has a relatively short duration of action, requiring dosing 3 to 4 times daily, but extended-release formulations are available that allow for once-daily dosing. As verapamil is a negative inotropic medication (i.e. it decreases the strength of myocardial contraction), it should not be used in patients with severe left ventricular dysfunction or hypertrophic cardiomyopathy as the decrease in contractility caused by verapamil may increase the risk of exacerbating these pre-existing conditions.
Side Effects
May increase plasma level with CYP3A4 inhibitors (e.g. erythromycin, ritonavir), cimetidine. May decrease plasma level with CYP3A4 inducers (e.g. rifampicin), phenobarbital, sulfinpyrazone. Increased risk of bleeding with aspirin. May increase bradycardic and hypotensive effect with telithromycin. Increased AV blocking effect with clonidine. May increase plasma level of cardiac glycosides (e.g. digoxin, digitoxin), ?-blockers (e.g. propranolol, metoprolol), ?-blockers (e.g. terazosin, prazosin), immunosuppressants (e.g. sirolimus, ciclosporin, tacrolimus, everolimus), lipid lowering agents (e.g. lovastatin, simvastatin, atorvastatin), colchicines, quinidine, carbamazepine, imipramine, glibenclamide, doxorubicin, midazolam, buspirone, almotriptan, theophylline. May potentiate hypotensive effect with diuretics, antihypertensives, vasodilators. May increase neurotoxic effect of lithium.
Pregnancy And Lactation
Severe left ventricular dysfunction Hypotension or cardiogenic shock Sick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker) Second or third-degree atrioventricular (AV) block (except in patients with a functioning artificial pacemaker) Patients with atrial flutter or atrial fibrillation and an accessory by pass tract (eg. Wolff-Parkinson-White, Lown-Ganong-Levine syndrome) Patients with known hypersensitivity to verapamil hydrochloride
Therapeutic
Care should be taken in 1st degree AV block, bradycardia <50 beats/minutes, hypotension <90 mm Hg systolic pressure, atrial fibrillation/flutter and simultaneous pre-excitation syndrome e.g. WPW syndrome, heart failure (previous compensation with cardiac glycosides/diuretics required). Verapamil may impair ability to drive or operate machinery, particularly in the initial stages of treatment and with concomitant consumption of alcohol. Verapamil markedly slows down the elimination of alcohol and prolongs the duration of the effects of alcohol.
Storage Conditions
Treatment of overdose should be supportive. Beta-adrenergic stimulation or parenteral administration of calcium solution may increase calcium ion flux across the slow channel and have been used in the treatment of overdose with Verapamil. Verapamil cannot be removed by hemodialysis.
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