- What is verapamil, and how does it work (mechanism of action)?
- What brand names are available for verapamil?
- Is verapamil available as a generic drug?
- Do I need a prescription for verapamil?
- What are the side effects of verapamil?
- What is the dosage for verapamil?
- Which drugs or supplements interact with verapamil?
- Is verapamil safe to take if I'm pregnant or breastfeeding?
- What else should I know about verapamil?
What is the dosage for verapamil?
Verapamil can be taken with food.
- Angina (immediate release formulations): 80-160 mg three times daily. Angina (extended release formulations): 180-540 mg at bedtime.
- Hypertension (immediate release): 80-320 mg twice daily. Hypertension (extended release): 120-480 mg once or twice daily depending on the brand.
- Migraine: 160-320 mg three to four times daily.
Which drugs or supplements interact with verapamil?
Concurrent use of verapamil with a beta blocker (another class of medications that slow heart rate) can cause profound and dangerous reductions in heart rate. Verapamil can raise the levels of some drugs in blood including digoxin (Lanoxin), theophylline (Slo-Bid), cyclosporin, and carbamazepine (Tegretol). Therefore, monitoring of the levels of these drugs is important to avoid toxicity.
Verapamil may reduce blood levels of lithium (Eskalith, Lithobid) in some patients. For unclear reasons some patients who took both verapamil and lithium have noticed increased side effects of lithium without increases in their blood levels of lithium.
The use of "statins" (for example, simvastatin or lovastain) in combination with verapamil has been associated with reports of myopathy/rhabdomyolysis because verapamil reduces the break down of these statins in the liver. The dose of simvastatin in patients on verapamil should not exceed 10 mg daily and the dose of lovastatin (Mevacor, Altoprev) should not exceed 40 mg daily. Lower starting and maintenance doses of other statins (for example, atorvastatin [Liptor]) may be required since verapamil also may increase the plasma concentration of these drugs also. Rifampin and phenobarbital increase the elimination of verapamil, potentially reducing the effect of verapamil.
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