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Back to Cardiology Drug index
Name: Verapamil hydrochloride
Pregnancy Category C
Drug classes
- Calcium channel-blocker
- Antianginal drug
- Antiarrhythmic drug
- Antihypertensive
Therapeutic actions
Inhibits the movement of calcium ions across the membranes of cardiac
and
arterial muscle cells; calcium is involved in the generation of the
action potential in specialized automatic and conducting cells in the
heart, in arterial smooth muscle, and in excitation-contraction
coupling
in cardiac muscle cells; inhibition of transmembrane calcium flow
results
in the depression of impulse formation in specialized cardiac
pacemaker
cells, slowing of the velocity of conduction of the cardiac impulse,
the
depression of myocardial contractility, and the dilation of coronary
arteries and arterioles and peripheral arterioles; these effects lead
to
decreased cardiac work, decreased cardiac energy consumption, and in
patients with vasospastic (Prinzmetal's) angina, increased delivery of
oxygen to myocardial cells.
Indications
- Angina pectoris due to coronary artery spasm (Prinzmetal's variant
angina)
- Effort-associated angina
- Chronic stable angina in patients who cannot tolerate or do not
respond
to beta-adrenergic blockers or nitrates
- Unstable, crescendo, preinfarction angina
- Essential hypertension (sustained-release oral)
- Treatment of supraventricular tachyarrhythmias (parenteral)
- Temporary control of rapid ventricular rate in atrial flutter or
atrial
fibrillation (parenteral)
- Unlabeled oral uses: paroxysmal supraventricular tachycardia, migraine
headache, nocturnal leg cramps, hypertrophic cardiomyopathy
Contraindications/cautions
Contraindicated in the presence of allergy to verapamil; sick sinus
syndrome, except in presence of ventricular pacemaker; heart block
(second- or third-degree); hypotension; pregnancy; lactation.
Use caution in the presence of idiopathic hypertrophic subaortic
stenosis, cardiogenic shock, severe CHF, impaired renal or hepatic
function.
Adverse effects
- CNS: Dizziness, vertigo, emotional depression, sleepiness, headache
- GI: Nausea, constipation
- CV: Peripheral edema, hypotension, arrhythmias, bradycardia; AV heart
block
- Other: Muscle fatigue, diaphoresis
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