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Verapamil is available as a 40 mg, 80 mg, and 120 mg oral tablet.

Verapamil is a calcium channel blocker (CCB) used for chest pain (angina), the prevention and treatment of certain types of arrhythmias, and high blood pressure.

Verapamil is a non-dihydropyridine calcium channel blocker. It lowers blood pressure and helps with irregular heart rhythm (arrhythmia) by slowing your heart rate and relaxing your blood vessels. This also helps your heart to get more oxygen so it doesn’t need to work as hard to pump, which can help with chest pain.

Verapamil is typically taken by mouth 3 to 4 times a day. Your physician may adjust your dose based on things like how well you’re responding to the medication, your age, your height, if you have liver problems, and if you’re having side effects.

Verapamil is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not take this medication if you have severe left ventricular dysfunction, hypotension (systolic pressure less than 90 mm Hg) or cardiogenic shock, sick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker), second- or third-degree AV block (except in patients with a functioning artificial ventricular pacemaker), or atrial flutter or atrial fibrillation and an accessory bypass tract (eg, Wolff-Parkinson-White, Lown-Ganong-Levine syndromes).

Common side effects of Verapamil include:

• Constipation
• Dizziness
• Nausea
• Low blood pressure
• Headache
• Swelling in the hands and feet
• Tiredness
• Rash
• Flushing

Serious side effects are rare with Verapamil. Contact your healthcare provider immediately if you experience any of the following.

• Heart failure: chest pain, difficulty breathing, dizziness, tiredness, swollen legs and feet, bloating
• Dangerously low blood pressure: dizziness, lightheadedness, pale skin, feeling faint
• Liver problems: severe nausea, vomiting, right-sided stomach pain, fatigue, low or no appetite, yellowing of the skin or eyes

The following medications may interact with Verapamil:

• Cytochrome inducers/inhibitors – Clinically significant interactions have been reported with inhibitors of CYP3A4 (e.g., erythromycin, ritonavir) causing elevation of plasma levels of Verapamil while inducers of CYP3A4 (e.g., rifampin) have caused a lowering of plasma levels of Verapamil
• HMG-CoA reductase inhibitors: The use of HMG-CoA reductase inhibitors that are CYP3A4 substrates in combination with Verapamil has been associated with reports of myopathy/rhabdomyolysis
• Ivabradine – Concurrent use of Verapamil increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances. Avoid co-administration of Verapamil and ivabradine
• Aspirin – In a few reported cases, co-administration of Verapamil with aspirin has led to increased bleeding times greater than observed with aspirin alone
• Grapefruit juice – Grapefruit juice may increase plasma levels of Verapamil.
• Alcohol – Verapamil may increase blood alcohol concentrations and prolong its effects
• Lithium – Increased sensitivity to the effects of lithium (neurotoxicity) has been reported during concomitant Verapamil-lithium therapy; lithium levels have been observed sometimes to increase, sometimes to decrease, and sometimes to be unchanged. Patients receiving both drugs must be monitored carefully

Various FDA-approved generic manufacturers

It is not known if Verapamil will harm your unborn baby. If you become pregnant while receiving Verapamil, talk to your healthcare provider.

• Calan
• Calan SR