Verapamil, 240mg retard pills, 20pcs

Composition

1 tablet contains 240 mg of verapamil.

Pharmacological action

Verapamil is a class I selective calcium channel blocker.

The main pharmacological properties of the drug are due to its ability to prevent the entry of calcium ions into cardiomyocytes and smooth muscle cells of the vascular wall through slow calcium channels of the membrane.

Verapamil has antiarrhythmic, antianginal and antihypertensive activity.

Reduces myocardial oxygen demand by reducing myocardial contractility and reducing heart rate. Causes dilation of the coronary arteries and increased coronary blood flow. The antihypertensive effect of Verapamil is associated with a decrease in the smooth muscle tone of peripheral arteries and with the ability to reduce OPSS.

By slowing down AV conduction, Verapamil has an antiarrhythmic effect in supraventricular arrhythmias, the normal heart rate remains unchanged or decreases slightly.

Verapamil also has some natriuretic and diuretic effects by reducing tubular reabsorption.

Indications

Paroxysmal supraventricular tachycardia (except for WPW-syndrome), sinus tachycardia, atrial extrasystole, atrial fibrillation and flutter, angina pectoris (including Prinzmetal, tension, post-infarction), arterial hypertension, hypertensive crisis, idiopathic hypertrophic subaortic stenosis, hypertrophic cardiomyopathy.

Contraindications

• ardiogenic shock;
• severe bradycardia;
• sinus node weakness syndrome;
• AV block II-III degree;
• Wolff-Parkinson-White syndrome;
• arterial hypotension;
• chronic heart failure II – III stage, acute heart failure;
• hypersensitivity to the drug.

Side effects

From the cardiovascular system:  bradycardia (less than 50 beats/min), marked reduction in blood pressure, the development or the worsening of heart failure, tachycardia; rarely angina, until the development of myocardial infarction (especially in patients with severe obstructive coronary artery disease), arrhythmia (including atrial fibrillation and ventricular); with the rapid on/in the introduction, AV-block III degree, asystole, collapse.

From the central nervous system and peripheral nervous system:  dizziness, headache, fainting, anxiety, lethargy, increased fatigue, asthenia, drowsiness, depression, extrapyramidal disorders (ataxia, masked face, shuffling gait, stiffness of the hands or feet, trembling of the hands and fingers, difficulty swallowing).

From the digestive system:  nausea, constipation (rarely-diarrhea), gum hyperplasia (bleeding, soreness, swelling), increased appetite, increased activity of hepatic transaminases and alkaline phosphatase.

Allergic reactions: pruritus, skin rash, hyperemia of the facial skin, erythema multiforme (including Stevens-Johnson syndrome).

Other services:  weight gain, very rare-agranulocytosis, gynecomastia, hyperprolactinemia, galactorrhea, arthritis, transient vision loss on the background of Cmax, pulmonary edema, asymptomatic thrombocytopenia, peripheral edema.

Interaction

Concomitant use of Verapamil and beta-blockers, antiarrhythmic drugs, and inhaled anesthesia may lead to a mutual increase in their cardiodepressive effects (AV block, bradycardia, hypotension, and heart failure). When used concomitantly with quinidine, patients with hypertrophic obstructive cardiomyopathy may develop severe hypotension and pulmonary edema.

When Verapamil is co-administered with other antihypertensive drugs, there is a mutual potentiation of their effects. Verapamil can significantly increase the concentration of digoxin in plasma, which requires a reduction in the dose of cardiac glycoside when co-administered. The neurotoxic effect of Verapamil is potentiated by carbamazepine and lithium salts, and the psychotropic effect of lithium when co-administered with verapamil is weakened.

The concentration of cyclosporine or theophylline in blood plasma increases when co-administered with Verapamil. Rifampicin, phenytoin, phenobarbital and cimetidine can reduce the concentration of Verapamil in plasma and reduce the effectiveness of the latter. Verapamil potentiates the action of muscle relaxants.

How to take, course of use and dosage

The dosage regimen of Verapamil hydrochloride is set individually.

Adults are prescribed an initial dose of 40-80 mg 3 times a day.

The maximum daily dose is 480 mg.

Children aged 6-14 years are prescribed 80-360 mg per day, children under 6 years-40-60 mg per day;

the frequency of use is 3-4 times a day.

Tablets are taken with a meal or immediately after a meal, washed down with a small amount of water.

Overdose

Symptoms: bradycardia, AV block, marked decrease in blood pressure, heart rate, shock, asystole, SA block.

Treatment: for early detection – gastric lavage, activated charcoal; for rhythm and conduction disorders-intravenous isoprenaline, norepinephrine, atropine,10-20 ml of 10% calcium gluconate solution, artificial pacemaker; intravenous infusion of plasma-substituting solutions.

To increase blood pressure in patients with IGSS, alpha-adrenostimulants (phenylephrine) are prescribed; isoprenaline and norepinephrine should not be used.

Hemodialysis is ineffective.

Special instructions

With caution, the drug is prescribed to patients with impaired liver function, with acute myocardial infarction.

The use of Verapamil during pregnancy is possible only if the intended benefit to the mother exceeds the potential risk to the fetus.

When using the drug during lactation, the question of stopping breastfeeding should be decided.

With caution, Verapamil is prescribed to patients engaged in potentially dangerous activities that require increased attention and speed of motor and mental reactions.

Form of production

Pills.

Storage conditions

Store in a dry place, protected from light, at a temperature of 15-25 °C

Shelf life

5 years

Active ingredient

Verapamil

Conditions of release from pharmacies

By prescription

Dosage form

long-acting tablets

Description

For adults as directed by your doctor

Indications

Arrhythmia, Hypertension