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Legal classification of medication

POM

Verapamil tablets can only be obtained in accordance with a prescription given by an appropriate practitioner and therefore the legal status of the medication is prescription only medication (POM).

Formulations

Verapamil is available in four different formulations; tablets, capsules, oral solution, and injection. The strength of the drug will depend on the formulation used.

• Verapamil tablets: 40mg, 80mg, 160mg
• Oral solution: 40mg/5ml
• Injection: 2.5mg/1ml
• Securon SR®: 240mg
• Half Securon SR®: 120mg
• Univer®: 120mg, 180mg, 240mg
• Verapress MR®: 240mg
• Vertab® SR 240: 240mg

Class of drug

Non-dihydropyridine calcium channel blocker

Indications

• Supraventricular arrhythmias: These are abnormally fast heart rhythms which originate from anywhere in the top 2 chambers (atria) of the heart.
• Angina pectoris: Chest pains occurring when demand for blood by the heart exceeds the supply from the coronary arteries, usually results from a blockage of the coronary arteries
• Hypertension: High blood pressure

How does it work?

As a calcium channel blocker, Verapamil works by slowing down the rate at which calcium moves into the heart cells and into smooth muscle, which lines small blood vessels. Verapamil in particular has a powerful effect on the electrical wiring (specialized nerve tissue) of the heart. Verapamil is able to stop electrical signals being transmitted from the top two chambers (atria) of the heart to the electrical wiring in the bottom 2 chambers (ventricles). This effect is particular useful in patient suffering from supraventricular arrhythmias (see above).

How is it taken?

Verapamil is taken orally.

Pregnancy and breast feeding

Animal data suggests there are no harmful effects in pregnancy but there is only limited data regarding human pregnancy; therefore verapamil is only recommended when the clinical benefit clearly outweighs the risk of harm to the unborn foetus.

Verapamil is distributed in breast milk and should only be recommended when the clinical benefit to the mother clearly outweighs the risk of harm to the unborn foetus.

Contraindications

Verapamil should be avoided if you have any of the following apply to you. Please remember to always discuss with your own doctor before stopping any prescribed medication.

• Porphyria
• Heart failure
• Unstable angina
• Recent heart attack
• Hypersensitivity
• Sick sinus syndrome
• Lown-Ganong-Levine syndrome
• Wolff-Parkinson-White syndrome
• Grape fruit or juice consumption

Side Effects

The most common side-effects of Verapamil are due to its property of affecting the wiring of the heart. They include, in descending order of frequency:

• Slow heart rhythm
• Irregular heart rhythm
• Low blood pressure
• Constipation
• Headache
• Accumulation of fluid (oedema)
• Nausea
• Flushing
• Heart failure (usually only in overdose or with pre-existing heart damage)

If you experience any side effects, never stop your medication suddenly, always make an appointment to see your doctor as soon as possible and discuss any side effects or concerns with them.