Diseases of the heart and blood vessels very often cause death. Cardiac muscle ischemia occurs, as a rule, in elderly and middle-aged people. Inadequate blood supply to the heart muscle is the cause of the development of the disease.
An important role is played by a person’s lifestyle, the presence of bad habits, nutrition and lack of motor activity. An integrated approach is needed for treatment. Many doctors prescribe Verapamil in its composition. Instructions and analogues will be discussed later.
Types of the drug and its constituent components
Verapamil is available in the following forms:
- Pills in a shell.
- Injection.
- Dragee.
The main component of the drug is verapamil hydrochloride. Different forms of the drug may contain different concentrations of the active substance:
- The coated tablets contain 40 mg and 80 mg of the active ingredient. Of the additional ingredients: magnesium stearate, starch, calcium phosphate, hydroxypropyl methyl cellulose, butyl hydroxyanisole, gelatin, purified talc, methyl paraben, indigo carmine.
- Solution for injection (Verapamil in ampoules), 2 ml.
- Long-acting tablets contain 240 mg of active substance.
- Dragees are available in 40 mg and 80 mg.
Drug action
The main active ingredient, verapamil, is a calcium channel blocker. Reduces the oxygen demand of the heart muscle. The automatism of the sinus node is inhibited.
The drug has antiarrhythmic, antianginal and antihypertensive properties.
The half-life of the tablet form is from 3 to 7 hours, with repeated use, it increases from 4 to 12 hours. The active substance is metabolized in the liver. Absorbed more than 90% of the active substance. With plasma proteins, 90% of verapamil binds.
Who is assigned
The pill is prescribed if diagnosed:
- High blood pressure.
- ISHB.
- Stable angina and Prinzmetal angina.
- Heart rhythm disturbance.
Liquid medicine for intravenous administration is recommended for:
- Hypertensive crisis.
- Tachycardia.
- Acute coronary insufficiency.
- Ventricular arrhythmias.
- Atrial fibrillation and flutter.
In each case, a different drug may act better than Verapamil, but only the attending physician should deal with the appointment. Consider when you should not use the tool.
Who should not take the medicine
It is necessary to list the reasons why you should refuse to take "Verapamil":
- Severe heart failure.
- Low blood pressure
- Hypertrophic cardiomyopathy.
- Bradycardia
- Left ventricular obstruction.
- Galactosemia.
- Lactase deficiency.
- Glucose-galactose malabsorption.
- Sinoatrial block.
- Atrioventricular blockade of 2-3 degrees.
- Atrial fibrillation and flutter.
- Duchenne muscular dystrophy.
- Problems in the liver and kidneys.
Before surgery, discontinue therapeutic treatment with this drug.
"Verapamil" in the form of tablets is not prescribed for children who are less than 5 years old, since it is not known how safe the drug is at this age.
Pregnant and lactating women are not recommended to use the drug. But therapy is possible if the benefit outweighs the risks. The active substance passes into milk, therefore it is better to transfer the baby to artificial feeding during the treatment period.
Patients with hypersensitivity to the components of Verapamil should refuse to take it.
When working with dangerous machinery and when driving vehicles, Verapamil should not be taken. If it is necessary to use a medicine, one must refrain from driving and from work that requires a high concentration of attention.
Features of the use of tablets
"Verapamil" tablets, the instructions indicate this, are intended for oral use. You can drink at any time, regardless of food intake. The tablet should not be chewed or crushed. Swallowing a whole, it must be washed down with a sufficient amount of water.
The dosage and course of treatment are prescribed by a specialist for each patient individually. With prolonged use of the drug, it is necessary to monitor the performance of the liver.
Recommended doses of the drug for some diseases should be given:
- With angina pectoris and arrhythmias, 80-120 mg 3 times a day is recommended.
- With arterial hypertension - 80 mg 3 times a day. In the absence of the desired effect, the dosage after 7 days of administration can be gradually increased.
- The prolonged form of the drug is taken at 240 mg per day. The dose can be divided into two doses of 120 mg. Over time, it is gradually reduced. The interval between taking prolonged tablets with a two-time intake should be 12 hours.
- With a small weight, it is recommended at the initial stage to use no more than 40 mg 3 times a day. This dosage is prescribed for patients aged, as well as for those who have impaired functioning of organs such as the liver of the kidney. Gradually, the dose can be increased if the desired result is not achieved.
The highest dosage of Verapamil is determined - it is 480 mg per day.
Injection medication
Verapamil in the form of a solution is used parenterally. Intravenously administered, can be infused.
For infusions, the medicine is prepared together with 5% glucose or with 9% sodium chloride solution. The introduction should be slow, so that no more than 10 mg of the active substance of the drug per 1 hour gets into the body. The course of therapeutic treatment is prescribed by the doctor.
Consider some recommended doses of an intravenous administration of a medical product:
- With supraventricular tachycardia, 2-4 ml are recommended. Intravenous administration should be slow and last at least 2 minutes. If the desired result did not occur after 20-30 minutes, then a second dose of the drug is administered.
- For hypertensive crisis, a medicine is recommended at a rate of 0.05-0.1 mg / kg body weight. Introduced into a vein slowly. In the absence of the desired effect, after 30-60 minutes, you can enter the medicine a second time.
The highest dosage of Verapamil for intravenous administration is 100 mg per day.
With the introduction of the solution into the vein, you need to constantly monitor the patient's blood pressure and heart function.
Methods of taking the drug for children
“Verapamil” is prescribed for children with arrhythmias and high blood pressure.
It is recommended to use the medicine in tablets in the following dosages:
- kids 5 years old up to 60 mg per day;
- at the age of 6 to 14 years - 60-360 mg per day.
If the child is under 5 years old, it is recommended to inject into a vein:
- children up to a year 0.75-2 mg.
- from one to five years, the dosage is 2-3 mg.
The required dosage of the drug can be calculated based on the weight of the child. For intravenous administration, it is 0.1-0.3 mg / kg per body weight. The largest dose at a time for children is 5 mg of Verapamil.
If, after administration of the drug, the desired effect has not been achieved, a second dose can be administered after 30-60 minutes.
Side effects of Verapamil
It is worth noting that a negative effect on the body when taking the drug is possible.
The cardiovascular system can respond to the drug as follows:
- Blood pressure will greatly decrease.
- Heart rate may be disturbed.
- An angina attack will develop.
- The heartbeat will intensify.
- Sinoatrial or atrioventricular block is possible.
There is a risk:
- The development of heart failure.
- Short-term loss of consciousness.
- Myocardial infarction.
Side effects of Verapamil are also expressed:
- Nausea.
- Vomiting.
- Constipation or diarrhea.
- Bleeding gums.
- Dry oral mucosa.
- Hyperbilirubinemia.
- Increased liver function.
Perhaps with prolonged use of Verapamil, its toxic effect on liver cells will increase.
Side effects characteristic of Verapamil are as follows:
- Bouts of headache.
- Dizziness.
- Cramps.
- Cerebrovascular accident.
- Problems with vision and hearing.
- Tinnitus.
- Trouble sleeping.
- Paresthesia.
- Tremor.
- Extrapyramidal disorders.
Genitourinary system and reproductive organs:
- Menstrual cycle failure.
- Frequent urination.
- Erectile disfunction.
- Gynecomastia
Negative manifestations from other organs and systems:
- Skin rashes.
- Pigmentation of the skin.
- Alopecia.
- Bronchospasm.
- Quincke's edema.
- The appearance of hematomas.
- Sore muscles, myalgia.
Side effects may occur when taken in conjunction with other means.
Interaction with other drugs
Preparations with which the influence of Verapamil is enhanced:
- Antipsychotics.
- Tricyclic antidepressants.
Means that increase the concentration of the active substance in plasma:
- "Cimetidine."
- "Ritonavir."
- "Indinavir."
The combination with Verapamil of the following medications increase the negative manifestations of the heart and blood vessels:
- Inhalation anesthetics.
- Beta-adrenergic blockers.
- X-ray contrast agents.
- Neuromuscular blockers.
- "Flecainide" (antiarrhythmic drug).
Joint use of the above drugs is possible only under the strict supervision of a physician.
“Verapamil” increases the effect on the body:
- antihypertensive drugs;
- drugs to relax muscle fibers.
The plasma concentration of the following substances increases significantly when used together with Verapamil:
- "Cyclosporin."
- "Carbamazepine."
- "Tacrolimus."
- Colchicine.
- Inhibitors of serotonin receptors.
- Macrolides.
- Cardiac glycosides.
In such combinations, a dose adjustment is necessary.
The therapeutic effect of Verapamil weakens when used together:
- with calcium;
- cholecalciferol;
- inducers of microsomal liver enzymes.
Verapamil slows down excretion:
- Propranolol;
- "Phenobarbital";
- "Metoprolol";
- "Rifampicin."
You can not use Verapamil together:
- with antiarrhythmic drugs of 1-3 classes;
- "Disopyramide."
The use of these drugs is possible only 48 hours after taking Verapamil.
Together with "Quinidine", the patient may greatly decrease blood pressure.
A dose adjustment of Simvastatin is necessary when used together with Verapamil.
A change in pharmacokinetic parameters is possible with the simultaneous administration of drugs that are characterized by a high bond with plasma proteins.
Grapefruit juice increases the absorption of Verapamil into the systemic circulation.
It enhances the negative effect of alcohol on the body, so it is better to be from it during the treatment period.
It is worthwhile to carefully consider the side effects characteristic of Verapamil when taking other drugs with it.
Symptoms of overdose and relief
It is necessary to describe the symptoms of an overdose of Verapamil:
- Heart failure.
- Significant decrease in blood pressure.
- Asystole.
- Atrioventricular block.
With severe manifestations, it is recommended to perform the following actions:
- Rinse the stomach.
- Take enterosorbents.
- Laxatives
- Monitor breathing, heart rate, ECG and blood pressure.
- Assign, at the discretion of the doctor, inotropic drugs.
Perhaps the use of pacemakers. Hemodialysis with an overdose of Verapamil is not effective.
Analogues of the drug
The drug is not always suitable due to the composition of auxiliary components. It is very important to learn the instructions from Verapamil. Analogs have a similar effect. These include:
- "Riodipine."
- Amlodipine.
- Gallopamil.
- "Nifedipine."
- "Retard."
- Nimodipine
Similar active substance have:
- "Caveril."
- Finoptin.
- "Lecoptin."
- Isoptin.
An effective Verapamil preparation should be discussed with your doctor. The use of analogues also require the advice of a doctor.
Reviews about the drug
This drug is often prescribed for high blood pressure and arrhythmias. Has good "Verapamil" reviews. Analogs are required infrequently. It has a good effect on the heart system, normalizes blood pressure, and helps with angina pectoris. It is worth noting that some patients note the occurrence of side effects when taking Verapamil. Reviews indicate a possible violation of the stool and nausea, heart palpitations and dizziness. Several reviews contain information about headaches and sleep disturbances.
Many patients find the drug very effective and take it for a long time. So pass attacks of angina pectoris, less often blood pressure rises. Also note the affordable cost of Verapamil. Reviews about the analogues of the drug suggest that they are more expensive.
Some patients did not feel the therapeutic effect when taking the pills. Intravenous administration of the drug normalizes blood pressure and heart rate well. Often for people with very high blood pressure, repeated administration of the Verapamil preparation is required. Instructions, reviews note this, it contains the recommended dosage, so you need to consult a doctor before taking the remedy.
If there are problems with the liver and kidneys, it is better not to prescribe the drug and find a replacement for it. Pregnant women can take a medicine to reduce uterine tone and with tachycardia. The use of Verapamil, patient reviews confirm this, will be effective if the drug is prescribed by a doctor after a full examination. The rhythm of the heart is normalized, the child becomes calmer. Some patients felt weak and dizzy while taking the pills. In this case, you should cancel the tool and find a replacement.
It is worth noting that you do not need to start taking the drug yourself without consulting a doctor. Side effects of Verapamil and contraindications should be studied and taken into account. Its effect depends on this.