Verapamil hydrochloride tablets are used for the following indications:
Coronary heart disease, including: stable angina pectoris; unstable angina (progressive angina, angina at rest), vasospastic angina (variant angina, Prinzmetal's angina), post-infarction angina in patients without heart failure, if β-blockers are not indicated; arrhythmias: paroxysmal supraventricular tachycardia; atrial flutter / fibrillation with rapid atrioventricular conduction (except Wolff-Parkinson-White syndrome (WPW)); arterial hypertension.
Composition
The active substance is verapamil (one tablet contains verapamil hydrochloride in terms of 100% substance 40 mg).
Excipients: lactose monohydrate, corn starch, sugar, povidone, magnesium stearate.
Contraindication
Hypersensitivity to verapamil or any component of the drug; cardiogenic shock; II or III degree block (except in patients with a functioning artificial pacemaker); sick sinus syndrome (except in patients with a functioning artificial pacemaker); heart failure with a decrease in ejection fraction of less than 35% and / or pulmonary artery pressure above 20 mm Hg (unless secondary supraventricular tachycardia is not affected by verapamil therapy); atrial fibrillation / flutter in the presence of additional conduction pathways (WPW syndrome and LGL syndrome); such patients are at risk of developing ventricular tachyarrhythmia, including ventricular fibrillation, when using verapamil hydrochloride; do not use intravenous β-blockers simultaneously during treatment (except in intensive care).
Method of application
The dosage is determined individually for each patient. The drug should be taken without dissolving or chewing, with a sufficient amount of liquid (for example, 1 glass of water, in no case grapefruit juice), preferably during or immediately after a meal.
Adults and adolescents weighing more than 50 kg
Coronary heart disease, paroxysmal supraventricular tachycardia, atrial flutter/fibrillation. The recommended daily dose is 120-480 mg in 3-4 divided doses. The maximum daily dose is 480 mg.
Arterial hypertension. The recommended daily dose is 120-360 mg, divided into 3 doses.
Children
The drug is used only for heart rhythm disorders.
Recommended dose:
children of older preschool age up to 6 years - within 80-120 mg per day, divided into 2-3 doses. children aged 6-14 years - within 80-360 mg per day, divided into 2-4 doses.
Do not take the drug while lying down.
The drug should not be prescribed to patients with myocardial infarction within 7 days after the event.
After prolonged therapy, the drug should be discontinued by gradually reducing the dose.
The duration of treatment is determined by the doctor individually and depends on the patient's condition and the course of the disease.
Application features
Pregnant women
There are no clear and well-controlled data on the use of the drug in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. Since data obtained from animal reproduction studies cannot always be extrapolated to humans, the drug should be used during pregnancy only if clearly needed.
Verapamil crosses the placenta and is detected in cord blood.
Verapamil and its metabolites are excreted in human milk. Limited oral data in humans suggest that the dose of verapamil that reaches the newborn is low (0.1-1% of the maternal dose), so the use of verapamil may be compatible with breastfeeding, but a risk to the newborn cannot be excluded. Because of the risk of serious adverse reactions in breastfed infants, verapamil should be used during breastfeeding only if clearly needed for the mother.
Drivers
Due to the antihypertensive effect of verapamil hydrochloride, depending on the individual response, the ability to drive vehicles, operate machinery or work in hazardous conditions may be impaired. This is especially true in the initial phase of treatment, when increasing the dose, when changing the antihypertensive drug, as well as when taking the drug with alcohol. Verapamil can increase the level of alcohol in the blood plasma and slow down its elimination, so the effect of alcohol may be enhanced.
Overdose
Symptoms: hypotension, bradycardia to high-degree atrioventricular block and sinus node arrest, hyperglycemia, stupor and metabolic acidosis. Fatalities have been reported as a result of overdose.
In case of significant hypotension or high-degree atrioventricular block, it is necessary to use agents that increase blood pressure (vasoconstrictors) or pacemakers, respectively. In case of asystole, β-adrenergic stimulation (for example, isoproterenol hydrochloride), other agents aimed at increasing blood pressure or restoring cardiac activity and respiration should be used simultaneously with the use of conventional measures.
Verapamil hydrochloride is not removed by hemodialysis.
Side effects
The most frequently observed adverse reactions were: headache, dizziness, gastrointestinal disorders: nausea, constipation, abdominal pain; also bradycardia, tachycardia, palpitations, decreased blood pressure, flushing, peripheral edema and fatigue.
Storage conditions
Store in the original packaging at a temperature not exceeding 25 °C, out of the reach of children.
Shelf life - 5 years.
