Isoptin SR

Verapamil HCl

HTN.

Individualized dosage. Adult 1 tab in the morning. If after about 2 wk of treatment a dose increase is found necessary, increased to max of 2 tab daily. Long-term treatment: Should not exceed 480 mg daily. Patient w/ hepatic cirrhosis 40 mg bd-tds.

Should be taken with food: Preferably taken w/ or shortly after meals. Swallow whole w/ some fluid, do not suck, chew/crush.

Hypersensitivity. Cardiogenic shock; 2nd- or 3rd-degree AV block (except in patients w/ a functioning artificial pacemaker); sick sinus syndrome (except in patients w/ a functioning artificial pacemaker); CHF &/or severe left ventricular dysfunction (eg, reduced ejection fraction <35% &/or pulmonary wedge pressure >20 mmHg); atrial fibrillation/flutter in the presence of an accessory bypass tract (eg, Wolff-Parkinson-White, Lown-Ganong-Levine syndromes); acute MI w/ complications (bradycardia, marked hypotension, left ventricular failure) & SA block. Concomitant use w/ ivabradine.

Heart block/1st degree AV block/asystole/bradycardia (<50 beats/min). Mutual potentiation of CV effects (higher grade AV block, higher grade lowering of heart rate, induction of heart failure & potentiated hypotension) w/ β-blockers. Asymptomatic bradycardia (36 beats/min) w/ timolol eye drops. Concomitant use of digoxin. Heart failure. Hypotensive symptoms of lethargy & weakness w/ faintness. HMG-CoA reductase inhibitors. Neuromuscular transmission disorders (myasthenia gravis, Lambert-Eaton syndrome, advanced Duchenne muscular dystrophy). Risk of inducing ventricular tachycardia. Renal impairment. Severe liver impairment. May affect ability to drive & operate machinery. Do not give during pregnancy (especially 1st trimester). Lactation.

Dizziness, headache; bradycardia; flushing, hypotension; constipation, nausea; peripheral edema.

Increased C_max of prazosin. Increased AUC & C_max of terazosin, glyburide, colchicine, doxorubicin, buspirone, midazolam, metoprolol, propranolol, everolimus, simvastatin, almotriptan, dabigatran & grapefruit juice. Increased AUC of carbamazepine, imipramine & sirolimus. Increased C_max, C_12hr, C_ss & AUC of digoxin. May increase systemic bioavailability of other direct oral anticoagulants. Increased AUC, C_ss & C_max of cyclosporine. Possible increase of tacrolimus, lovastatin & ethanol (alcohol) levels. Increased AUC w/ & possible increased levels of atorvastatin. Sensitivity to lithium effects (neurotoxicity). Decreased oral clearance of quinidine. Decreased oral & systemic clearance of theophylline. Decreased total body & extrarenal clearance of digitoxin. Decreased plasma conc w/ phenytoin. Decreased AUC, C_max & oral bioavailability w/ rifampicin. Decreased bioavailability w/ sulfinpyrazone. Decreased AUC & C_max w/ St. John's wort. Possible increased levels w/ clarithromycin, erythromycin & telithromycin. Increased oral clearance w/ phenobarb & sulfinpyrazone. Increased AUC w/ cimetidine w/ corresponding decreased clearance. Increased C_trough w/ everolimus. Increased AUC & C_max w/ lovastatin. Increased plasma conc w/ HIV antiviral agents (eg, ritonavir). Increased risk of bleeding w/ acetylsalicylic acid. May potentiate activity of neuromuscular blockers (curare-like & depolarizing) & hypotensive effect of antihypertensives, diuretics & vasodilators. HMG CoA reductase inhibitors. Reduced efficacy of metformin when co-administered.

Calcium Antagonists

C08DA01 - verapamil ; Belongs to the class of phenylalkylamine derivative selective calcium-channel blockers with direct cardiac effects. Used in the treatment of cardiovascular diseases.

POM