Isoptin

Contents:

Verapamil hydrochloride

Dosage :

Chronic hypertension

Adult

80-160 mg two to three times daily

Hypertensive crisis

1 mg slowly IV, repeat after 5-10 minutes if required.

Chronic stable & unstable angina at rest including vasospastic angina. Long-term therapy after myocardial infarction; prophylaxis & treatment of supraventricular tachyarrhythmias

Adult

40 mg drag or 40 mg drag two to four times daily. In oral long-term therapy, max : 480 mg.

Contraindications:

CV shock, complicated acute myocardial infarction (bradycardia, marked hypotension, left ventricular failure); severe conduction disorders ( 2nd or 3rd degree AV block, SA block), sick-sinus syndrome ( bardycardia-tachycardia syndrome).

Special Precautions:

1st degree AV block, bradycardia < 50beats/mins, hypotension < 90 mmHg systolic pressure, atrial fibrillation/flutter & simultaneous pre-excitation syndrome eg WPW syndrome ( risk of inducing ventricular tachycardia), heart failure ( compensation with cardiac glycosides). May impair ability to drive or operate machinery. Pregnancy, lactation.

Adverse Reactions:

Bradycardiac arrhythmias; constipation;

Rarely

Nausea, vertigo or dizziness, headache, flushing, fatigue, nervousness, ankle edema, erythromelalgia, paresthesia;

Very rarely

Myalgia, arthralgia; allergic skin reactions; gynecomastia, reversible  increase in transaminases &/or alkaline phosphatase; gingival hyperplasia.

Drug interactions:

Cardiovascular effects enhanced by β-blockers, antiarrhythmics or inhalation anesthetic. May intensify BP-lowering effect of other antihypertensives. Rise in digoxin plasma levels when used with verapamil. Potentiate neurotoxic side effects of carbamazepine. Attenuate enhanced neurotoxicity of lithium. Increases plasma level of cyclosporin & theophylline. Effects attenuated by rifampicin. Effect of muscle relaxants may be potentiated.

Presentation/Packing:

Drag 40 mg x 100's, 500's. 80 mg x 250's.

Retard drag 120 mg x 20's. 240 mg x 20's.

Amploules 5 mg x 2 mL x 5's