Verapamil

Verapamil is used to treat high blood pressure and to control angina (chest pain). The immediate-release tablets are also used alone or with other medications to prevent and treat irregular heartbeats. Verapamil is in a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart and slows electrical activity in the heart to control the heart rate.

Verapamil comes as a tablet, an extended-release (long-acting) tablet, and an extended-release capsule to take by mouth. The regular tablet is usually taken three to four times a day. The extended-release tablets and capsules are usually taken once or twice a day. Take verapamil at around the same time(s) every day. Certain verapamil products should be taken in the morning and others at bedtime. Ask your doctor what the best time is for you to take your medication. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take verapamil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the extended-release tablets and capsules whole. Do not chew or crush them. Ask your pharmacist if the tablets may be split in half, as the instructions vary by product. If you can not swallow the extended-release capsules you may carefully open the capsule and sprinkle the entire contents onto a spoonful of applesauce. The applesauce should not be hot, and it should be soft enough to be swallowed without chewing. Swallow the applesauce immediately without chewing, and then drink a glass of cool water to make sure that you have swallowed all of the medicine. Do not store the mixture for future use. Your doctor will probably start you on a low dose of verapamil and gradually increase your dose. Verapamil controls arrhythmias, high blood pressure, and angina but does not cure these conditions. Continue to take verapamil even if you feel well. Do not stop taking verapamil without talking to your doctor.

<p></p> <p></p> <p></p> <p>Verapamil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

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constipation</li>
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heartburn</li>
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dizziness or lightheadedness</li>
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headache</li></ul></p> <p></p> <p>Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

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swelling of the hands, feet, ankles, or lower legs</li>
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difficulty breathing or swallowing</li>
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slow heartbeat</li>
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fainting</li>
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blurred vision</li>
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rash</li>
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nausea</li>
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extreme tiredness</li>
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unusual bleeding or bruising</li>
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lack of energy</li>
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loss of appetite</li>
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pain in the upper right part of the stomach</li>
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yellowing of the skin or eyes</li>
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flu-like symptoms</li>
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fever</li></ul>If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at <a href='http://www.fda.gov/Safety/MedWatch'>http://www.fda.gov/Safety/MedWatch</a>] or by phone [1-800-332-1088].</p>

Before taking verapamil, tell your doctor and pharmacist if you are allergic to verapamil or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as prazosin (Minipress); antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); aspirin; beta blockers such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), propranolol (Inderal), and timolol (Betimol, Istalol, Timoptic, in Cosopt); carbamazepine (Tegretol); cimetidine (Tagamet); clarithromycin (Biaxin, in Prevpac); cyclosporine (Neoral, Sandimmune); digoxin (Lanoxin, Lanoxicaps); disopyramide (Norpace); diuretics (''water pills'');erythromycin (E.E.S., E-Mycin, Erythrocin); flecainide (Tambocor); certain HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); quinidine (Quinaglute, Quinidex); lithium (Eskalith, Lithobid); medications to treat high blood pressure; nefazodone; phenobarbital; pioglitazone (Actos, in Duetact); rifampin (Rifadin, Rimactane); telithromycin (Ketek); and theophylline (Theolair, Uniphyl). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with verapamil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. tell your doctor what herbal products you are taking, especially St. John's wort. tell your doctor if you have or have ever had narrowing or blockage of your digestive system or any other condition that causes food to move through your digestive system more slowly; heart failure; heart, liver, or kidney disease; muscular dystrophy (inherited disease that causes gradual weakening of muscles); or myasthenia gravis (condition that causes certain muscles to weaken). if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking verapamil. talk to your doctor about the safe use of alcoholic beverages during your treatment with verapamil. Verapamil may cause the effects of alcohol to be more severe and longer-lasting.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. Symptoms of overdose may include:

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dizziness</li>
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blurred vision</li>
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slow, fast, or irregular heartbeat</li>
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seizures</li>
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confusion</li>
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difficulty breathing or swallowing</li></ul>