Angimil 40 mg (Tablet)
Medicine Details
| Category | Details |
|---|---|
| Generic | Verapamil hydrochloride |
| Company | Medimet pharmaceuticals ltd |
| Also available as |
Product title
- Angimil Tablet
- Angimil Injection
Categories
- Medicine
- Healthcare
- Pharmaceutical
Description
Angimil is a calcium ion influx inhibitor that inhibits the inward movement of calcium into cardiomyocytes, smooth muscle cells and His-Purkingi system. The tablets are designed for sustained release of the drug in the intestine.
Pharmacology
Verapamil is an L-type calcium channel blocker with antiarrhythmic, antianginal, and antihypertensive activity. Immediate-release verapamil has a relatively short duration of action, requiring dosing 3 to 4 times daily, but extended-release formulations are available that allow for once-daily dosing. As verapamil is a negative inotropic medication (i.e. it decreases the strength of myocardial contraction), it should not be used in patients with severe left ventricular dysfunction or hypertrophic cardiomyopathy as the decrease in contractility caused by verapamil may increase the risk of exacerbating these pre-existing conditions.
Dosage and administration
- Dosing should be individualized by titration and the drug should be administered with food
- Dosage varies for essential hypertension, angina, and arrhythmias
- Dosage for adults and children differ
- Recommended routes of administration include intravenous and oral
Interaction
- May interact with CYP3A4 inhibitors and inducers
- Interaction with aspirin, telithromycin, clonidine, cardiac glycosides, β-blockers, α-blockers, immunosuppressants, lipid lowering agents, colchicines, quinidine, carbamazepine, imipramine, glibenclamide, doxorubicin, midazolam, buspirone, almotriptan, theophylline, diuretics, antihypertensives, vasodilators, lithium
Contraindications
- Severe left ventricular dysfunction
- Hypotension or cardiogenic shock
- Sick sinus syndrome
- Second or third-degree atrioventricular (AV) block
- Patients with atrial flutter or atrial fibrillation and an accessory by pass tract
- Known hypersensitivity to verapamil hydrochloride
Side effects
- Digestive system reactions include constipation and nausea
- Cardiovascular system reactions include hypotension, edema, CHF, pulmonary edema, bradycardia, AV block
- Respiratory system reactions include upper respiratory tract infections
- Nervous system reactions include dizziness, headache, fatigue
- Skin reactions include rash and flashing
- Hepatic reactions include elevated liver enzyme
Pregnancy and lactation
There are no adequate and well-controlled studies in pregnant women, so this drug should be used during pregnancy only if clearly needed. Verapamil crosses the placental barrier and can be detected in umbilical vein blood during delivery. Verapamil is excreted in breast milk. So nursing should be discontinued while Verapamil is administered.
Precautions and warnings
- Care should be taken in 1st degree AV block, bradycardia, hypotension, atrial fibrillation/flutter, simultaneous pre-excitation syndrome, heart failure
- Angimil may impair ability to drive or operate machinery, particularly in the initial stages of treatment and with concomitant consumption of alcohol
- Angimil markedly slows down the elimination of alcohol and prolongs the duration of the effects of alcohol
Overdose effects
Treatment of overdose should be supportive. Beta-adrenergic stimulation or parenteral administration of calcium solution may increase calcium ion flux across the slow channel and have been used in the treatment of overdose with Angimil. Angimil cannot be removed by hemodialysis.
Therapeutic class
Calcium-channel blockers
Storage conditions
Do not store above 30°C. Keep away from light and out of the reach of children.