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verapamil

verapamil (Isoptin)

introduction

  • a phenylalkylamine non-dihydropyridine calcium blocking agent
  • acts mainly on arteriolar smooth muscle to reduce peripheral vascular resistance as well as having negative inotropic and AV conduction effects

main indications

C/I

precautions

  • concomitant beta adrenergic blockers risk AV blockade
  • liver impairment
  • grapefruit juice as this is an inhibitor of the CYP-3A4 enzyme and may cause toxicity of verapamil and other calcium channel blockers
  • lactation

adverse effects

  • hypotension
  • negative inotropic effect and cardiac failure risk
  • cardiac conduction blockade
  • peripheral oedema which is NOT responsive to diuretics which will only cause volume depletion
  • constipation
  • rarely, myasthenia-like neuromuscular disease
  • many possible drug interactions

dose

acute ED Rx of SVT or hypertension

  • 3mg over 1-2min then 1mg per minute as needed up to 10mg max in adults
verapamil.txt · Last modified: 2015/12/31 15:28 (external edit)