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What is the most important information I should know about verapamil?

Do not stop taking this medication without first talking to your doctor. If you stop taking the medication, your condition could become worse.

Do not crush, chew, or break extended-release forms of verapamil such as generic Covera-HS and Verelan PM. Swallow them whole. Generic verapamil SR, Isoptin SR, and Calan SR may be divided in half but should not be crushed or chewed.

Warning

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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What is verapamil?

Verapamil is in a class of drugs called calcium channel blockers. Verapamil relaxes (widens) blood vessels (veins and arteries), which makes it easier for the heart to pump and reduces its workload.

Verapamil is used to treat hypertension (high blood pressure), to treat angina (chest pain), and to control some types of irregular heartbeats.

Verapamil may also be used for purposes other than those listed in this medication guide.


Precautions

Before taking this medication, tell your doctor if you have

  • kidney or liver disease;
  • other diseases of the heart or blood vessels such as sick sinus syndrome, aortic stenosis, heart failure, heart block, Wolff-Parkinson-White syndrome, coronary artery disease, or low blood pressure; or
  • muscular dystrophy.

You may not be able to take verapamil, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Verapamil is in the FDA pregnancy category C. This means that it is not known whether verapamil will be harmful to an unborn baby. Do not take verapamil without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Verapamil passes into breast milk and may harm a nursing infant. Do not take verapamil without first talking to your doctor if you are breast-feeding a baby.

Grapefruit and grapefruit juice may interact with verapamil. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Avoid the use alcohol. Alcohol may further lower blood pressure and increase drowsiness and dizziness while taking verapamil.

Follow any recommendations your doctor makes about diet or exercise.

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Instructions

Seek emergency medical attention.

Symptoms of a verapamil overdose include dizziness, weakness, chest pain, shortness of breath, fainting, an unusually fast or slow heartbeat, coma, slurred speech, and confusion.

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

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Side-effects

If you experience any of the following serious side effects, stop taking verapamil and contact your doctor immediately or seek emergency medical treatment:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • an unusually fast or slow heartbeat;
  • shortness of breath (heart failure);
  • fainting;
  • abnormal behavior or psychosis;
  • jaundice (yellowing of the skin or eyes); or
  • swelling of the legs or ankles.

Other, less serious side effects may be more likely to occur. Continue to take verapamil and talk to your doctor if you experience

  • unusual headache, fatigue, or tiredness;
  • insomnia or trouble sleeping;
  • vivid dreams;
  • hair loss;
  • nausea or diarrhea; or
  • increased urination.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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Interactions

Before taking this medication, tell your doctor if you are taking any of the following drugs:

  • cyclosporine (Sandimmune, Neoral);
  • cimetidine (Tagamet, Tagamet HB);
  • carbamazepine (Tegretol, Carbatrol);
  • lithium (Lithobid, Eskalith, others);
  • theophylline (Theo-Dur, Theochron, Theolair, Theobid, Elixophyllin, Slo-Phyllin, others);
  • rifampin (Rifadin, Rimactane);
  • phenobarbital (Luminal, Solfoton);
  • an HMG CoA reductase inhibitor such as atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor), and others; or
  • another heart medication such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), digoxin (Lanoxin), quinidine (Quinora, Quinidex, Quinaglute), flecainide (Tambocor), disopyramide (Norpace), captopril (Capoten), enalapril (Vasotec), and others.

You may not be able to take verapamil, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with verapamil or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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