Verapamil

1 tablet contains 80 mg of verapamil.

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 the slow calcium channels of the membrane.

Verapamil has antiarrhythmic, antianginal and hypotensive activity.

Reduces myocardial oxygen demand by reducing myocardial contractility and lowering the heart rate. Causes expansion of the coronary arteries and an increase in coronary blood flow.

The antihypertensive effect of Verapamil is associated with a decrease in the tone of smooth muscles of peripheral arteries and with the ability to reduce the systemic vascular resistance.

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.

• prevention of angina attacks (including Prinzmetal's angina);
• treatment and prevention of supraventricular arrhythmias (paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, extrasystole);
• arterial hypertension.

The use of verapamil during pregnancy is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

FDA category of action on the fetus - C.

During treatment, breastfeeding should be discontinued (verapamil is excreted in breast milk).

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

From the side of the cardiovascular system: bradycardia (less than 50 beats / min), a pronounced decrease in blood pressure, development or worsening of heart failure, tachycardia; rarely - angina pectoris, up to the development of myocardial infarction (especially in patients with severe obstructive coronary artery disease), arrhythmia (including fibrillation and flutter of the ventricles); with rapid intravenous administration - AV block of the III degree, asystole, collapse.

From the side of the central nervous system and peripheral nervous system: dizziness, headache, fainting, anxiety, lethargy, fatigue, asthenia, drowsiness, depression, extrapyramidal disorders (ataxia, mask-like 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), gingival hyperplasia (bleeding, soreness, swelling), increased appetite, increased activity of hepatic transaminases and alkaline phosphatase.

Allergic reactions: itching, skin rash, flushing of the facial skin, erythema multiforme exudative (including Stevens-Johnson syndrome).

Others: weight gain, very rarely - agranulocytosis, gynecomastia, hyperprolactinemia, galactorrhea, arthritis, transient loss of vision against the background of Cmax, pulmonary edema, asymptomatic thrombocytopenia, peripheral edema.

The simultaneous use of Verapamil and beta-blockers, antiarrhythmic drugs, agents for inhalation anesthesia can lead to a mutual enhancement of their cardiodepressive effects (AV blockade, bradycardia, hypotension, heart failure). With simultaneous use with quinidine in patients with hypertrophic obstructive cardiomyopathy, severe hypotension and pulmonary edema may develop.

With the simultaneous appointment of Verapamil with other antihypertensive drugs, a mutual potentiation of their effects is noted. Verapamil is able to significantly increase the concentration of digoxin in plasma, which requires a decrease in the dose of cardiac glycoside when administered together.

The neurotoxic effect of Verapamil is potentiated by carbamazepine and lithium salts, and the psychotropic effect of lithium when administered together with verapamil is weakened. The concentration of cyclosporine or theophylline in blood plasma increases when administered together with Verapamil. Rifampicin, phenytoin, phenobarbital and cimetidine are able to reduce the plasma concentration of Verapamil and reduce the effectiveness of the latter. Verapamil potentiates the action of muscle relaxants.

The dosage regimen of Verapamil 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 old - 40-60 mg per day; frequency of application 3-4 times a day.

Dragee is taken with meals or immediately after meals with a little water.

Symptoms: arterial hypotension, bradycardia, AV block, cardiogenic shock, coma, asystole.

Treatment: calcium gluconate is used as a specific antidote (10–20 ml of 10% solution in / in); with bradycardia and AV block, atropine, isoprenaline or orciprenaline are administered; with hypotension - plasma-substituting solutions, dopamine, norepinephrine; with the manifestation of signs of heart failure - dobutamine.

The drug is prescribed with caution 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 outweighs the potential risk to the fetus. When using the drug during lactation, the issue of stopping breastfeeding should be resolved.

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

Pills.