Verapamil

Verapamil is a medication used to treat high blood pressure, angina, and supraventricular tachycardia. It may also be used to prevent migraines and cluster headaches. It can be taken by mouth or injected into a vein.

History

Verapamil was approved for use in the United States in 1981 and is listed on the World Health Organization's List of Essential Medicines. It is available as a generic drug and long-acting formulations are available.

Popularity

In 2020, verapamil was the 151st most commonly prescribed medication in the United States, with over 3 million prescriptions.

Information about Verapamil

Verapamil is a first generation calcium channel blocker used for treatment of hypertension, angina pectoris and superventricular tachyarrhythmias.

Liver safety of Verapamil

Verapamil has been linked to a low rate of serum enzyme elevations during therapy and to rare instances of clinically apparent acute liver injury.

Mechanism of action of Verapamil

Verapamil (ver ap' a mil) belongs to the phenylalkylamine class of calcium channel blockers and is used to treat hypertension and angina pectoris as well as atrial tachyarrhythmias. Like other calcium channel blockers, verapamil acts by blocking the influx of calcium ions into vascular smooth muscle and cardiac muscle cells during membrane depolarization. This action causes relaxation of vascular and arterial smooth muscle cells, resulting in arterial vasodilation and a decrease in cardiac work and oxygen consumption. Verapamil also decreases the rate of the sinus node pacemaker and slows atrial-ventricular conduction, making it effective in controlling some superventricular tachyarrhythmias (an action not shared by all calcium channel blockers).

{fda}} Verapamil was the first calcium channel blocker approved in the United States (1981) and it remains in wide use with more than eight million prescriptions filled yearly.

Dosage and administration for Verapamil

Several generic formulations are available in tablet sizes of 40, 80 or 120 mg; specific commercial names include Calan, Isoptin, Apo-, Novo-, or Nu-Verap, and Verelan. For hypertension and angina pectoris, the recommended dose in adults is 120 to 480 mg daily in three divided doses. Chronic therapy is typical. Extended release formulations are available for once-daily dosing and intravenous formulations for treatment of atrial fibrillation or flutter.

Side effects of Verapamil

Like other calcium channel blockers, verapamil is generally well tolerated and side effects are largely due to its vasodilating activities and can include headache, flushing, dizziness, fatigue, nausea, diarrhea, palpitations, peripheral edema and skin rash.

calcium channel blockers

• amlodipine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nimodipine, nisoldipine, verapamil

Antihypertensive agents

• Dailymed label info on Verapamil
• FDA Verapamil

Verapamil Resources
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