Veracal SR 180 mg (Tablet)
Medicine Details
| Category | Details |
|---|---|
| Generic | Verapamil hydrochloride |
| Company | Incepta pharmaceuticals ltd |
| Also available as |
Title
- Veracal SR Tablet
Categories
- Medicine
- Healthcare
- Pharmaceutical
Description
Veracal SR 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.
Indications
- Essential hypertension
- Angina pectoris and prevention of re-infarction
- Supraventricular arrhythmias
- Tachycardias
- Atrial fibrillation with rapid ventricular response
- Atrial flutter with rapid conduction
- Extrasystoles
- Acute hypertension
- Acute coronary insufficiency
- Ectopic arrhythmias in halothane anaesthesia
- Application of adrenaline in halothane anaesthesia
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 & Administration
- Individualized dosing by titration
- Administered with food
- Dose titration for essential hypertension
- Usual dose for angina
- Dose for arrythmias in digitalized patients
- Intravenous dose for adults and children based on age and action
- Drip infusion for maintaining therapeutic effect
- Intravenous infusion in hypertensive crises
Interaction
- May increase plasma level with CYP3A4 inhibitors
- May decrease plasma level with CYP3A4 inducers
- Increased risk of bleeding with aspirin
- May increase bradycardic and hypotensive effect with telithromycin
- Increased AV blocking effect with clonidine
- May increase plasma level of cardiac glycosides, β-blockers, α-blockers, immunosuppressants, lipid lowering agents, colchicines, quinidine, carbamazepine, imipramine, glibenclamide, doxorubicin, midazolam, buspirone, almotriptan, theophylline
- May potentiate hypotensive effect with diuretics, antihypertensives, vasodilators
- May increase neurotoxic effect of 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
- Patients with known hypersensitivity to verapamil hydrochloride
Side Effects
- Constipation
- Nausea
- Hypotension
- Edema
- CHF
- Pulmonary edema
- Bradycardia
- AV block
- Upper respiratory tract infections
- Dizziness
- Headache
- Fatigue
- Rash
- Flashing
- Elevated liver enzyme
Pregnancy & Lactation
No adequate and well-controlled studies in pregnant women, so this drug should be used during pregnancy only if clearly needed
Precautions & Warnings
- Care in 1st degree AV block
- Bradycardia < 50 beats/minutes
- Hypotension < 90 mm Hg systolic pressure
- Atrial fibrillation/flutter and simultaneous pre-excitation syndrome
- Heart failure
- Impaired ability to drive or operate machinery
- Prolongs the duration of the effects of alcohol
Overdose Effects
Treatment should be supportive, beta-adrenergic stimulation or parenteral administration of calcium solution may increase calcium ion flux across the slow channel
Therapeutic Class
Calcium-channel blockers
Storage Conditions
Do not store above 30°C. Keep away from light and out of the reach of children