Diseases of the heart and blood vessels very often cause deaths. Ischemia of the heart muscle occurs, as a rule, in elderly and middle-aged people. Insufficient blood supply to the heart muscle is the cause of the development of the disease.
The lifestyle of a person, the presence of bad habits, nutrition and lack of physical activity play an important role. Treatment requires an integrated approach. Many doctors prescribe Verapamil in its composition. Instructions and analogues will be discussed further.
Types of drug and constituent components
Verapamil is available in the following forms:
- Coated tablets.
- Solution for injection.
- Dragee.
The main component of the drug is verapamil hydrochloride. Different forms of the medicinal product may contain different concentrations of the active substance:
- Coated tablets contain40 mg and 80 mg of the active ingredient. Additional Ingredients: Magnesium Stearate, Starch, Calcium Phosphate, Hydroxypropyl Methylcellulose, Butylhydroxyanisole, Gelatin, Purified Talc, Methylparaben, Indigo Carmine.
- Solution for injection ("Verapamil" in ampoules), 2 ml each.
- Long-acting tablets contain 240 mg of the active substance.
- Dragee is available in 40 mg and 80 mg.
Drug action
The main active ingredient, verapamil, is a calcium channel blocker. Reduces the need of the heart muscle for oxygen. The automatism of the sinus node is inhibited.
The drug has antiarrhythmic, antianginal and antihypertensive properties.
The half-life of the tablet form is 3 to 7 hours, with repeated use it increases from 4 to 12 hours. The active substance is metabolized in the liver. More than 90% of the active substance is absorbed. 90% of verapamil binds to plasma proteins.
Assigned to
Means in tablets are prescribed if diagnosed:
- High blood pressure.
- ISB.
- Stable angina and Prinzmetal's angina.
- Irregular heart rhythm.
Drug in liquid form for intravenous administration is recommended for:
- Hypertensive crisis.
- Tachycardias.
- Acute coronary insufficiency.
- Ventricular arrhythmias.
- Flicker and atrial flutter.
In each specific case, another drug may work better than Verapamil, but only the attending physician should deal with the appointment. Consider when not to use the remedy.
Who should not take medicine
It is necessary to list the reasons why you should refuse to take Verapamil:
- Severe heart failure.
- Low blood pressure.
- Hypertrophic cardiomyopathy.
- Bradycardia.
- Left ventricular obstruction.
- Galactosemia.
- Lactase deficiency.
- Glucose-galactose malabsorption.
- Sinoatrial blockade.
- Atrioventricular block 2-3 degree.
- Atrial fibrillation and flutter.
- Duchenne muscular dystrophy.
- Problems in the liver and kidneys.
The therapeutic treatment with this drug should be stopped before surgery.
Verapamil tablets are not prescribed to children under 5 years of age, as it is not known how safe the drug is at this age.
Pregnant and lactating women are not recommended to use the drug. But therapy is possible if the benefits outweigh the risks. The active substance enters the milk, so it is better to transfer the baby to artificial feeding for the period of treatment.
Patients with hypersensitivity to Verapamil components should stop taking it.
When working with dangerous machinery andwhen driving vehicles "Verapamil" should not be taken. If you need to use the drug, you must refrain from driving and from work that requires a high concentration of attention.
Features of the use of tablets
Tablets "Verapamil", the instructions indicate this, are intended for oral use. You can drink at any time, regardless of the meal. The tablet should not be chewed or crushed. When swallowing a whole, it must be washed down with enough water.
Dose and course of treatment is prescribed by a specialist for each patient on an individual basis. With prolonged use of the drug, it is necessary to monitor the performance of the liver.
Recommended doses of medicines for certain diseases should be given:
- For angina pectoris and arrhythmias, 80-120 mg 3 times a day is recommended.
- With arterial hypertension - 80 mg 3 times a day. In the absence of the desired effect, the dosage after 7 days of administration can be gradually increased.
- The prolonged form of the drug is taken at 240 mg per day. The dose can be divided into two doses of 120 mg. Over time, it is gradually reduced. The interval between taking extended-release tablets with two doses should be 12 hours.
- With a small weight, it is recommended at the initial stage to use no more than 40 mg 3 times a day. This dosage is also prescribed for aged patients, as well as for those whose work is impaired.organs such as the liver and kidneys. Gradually, the dose can be increased if the desired result is not achieved.
The highest dosage of "Verapamil" is determined - it is 480 mg per day.
Injection drug use
"Verapamil" in the form of a solution is used parenterally. Administered intravenously, can be infusion.
For infusions, the drug is prepared together with 5% glucose or 9% sodium chloride solution. The introduction should be slow so that no more than 10 mg of the active substance of the drug enters the body in 1 hour. The course of therapeutic treatment is prescribed by the doctor.
Let's take a look at some of the recommended intravenous doses of a medical device:
- For supraventricular tachycardia, 2-4 ml is recommended. Intravenous administration should be slow and last at least 2 minutes. If the desired result has not come after 20-30 minutes, then a second dose of the drug is administered.
- In case of hypertensive crisis, a medicine is recommended at the rate of 0.05-0.1 mg/kg of body weight. Introduced into a vein slowly. In the absence of the desired effect after 30-60 minutes, you can enter the medicine a second time.
The highest intravenous dosage of Verapamil is 100 mg per day.
When injecting a solution into a vein, you need to constantly monitor the patient's blood pressure and heart function.
Methods of taking the drug for children
Verapamil is prescribed for children with arrhythmia and high blood pressure.
Recommendeduse the medicine in tablets in the following dosages:
- babies 5 years old up to 60 mg per day;
- ages 6 to 14 - 60-360 mg per day.
If the child is under 5 years old, it is recommended to inject into a vein:
- children up to 1 year old 0.75-2 mg.
- from one to five years, the dosage is 2-3 mg.
You can calculate the required dosage of the drug based on the weight of the child. For intravenous administration, it is 0.1-0.3 mg / kg per body weight. The largest single dose for children is 5 mg Verapamil.
If after the administration of the drug the desired effect was not achieved, you can enter a second dose after 30-60 minutes.
Verapamil side effects
It is worth noting that a negative effect on the body when taking the drug is possible.
The cardiovascular system may respond to a drug as follows:
- Blood pressure will drop a lot.
- Heart rhythm may be disturbed.
- An angina attack will develop.
- Heartbeat will increase.
- Possible sinoatrial or atrioventricular block.
There is a risk:
- Development of heart failure.
- Short-term loss of consciousness.
- Myocardial infarction.
Side effects of "Verapamil" are also expressed:
- Nausea.
- vomit.
- Constipation or diarrhea.
- Bleeding gums.
- Dryness of oral mucosacavity.
- Hyperbilirubinemia.
- Increased liver function.
Possibly, with prolonged use of "Verapamil" its toxic effect on liver cells will increase.
Side effects are typical for "Verapamil" as follows:
- Headache attacks.
- Dizziness.
- Convulsions.
- Impaired cerebral circulation.
- Problems with vision and hearing.
- Tinnitus.
- Sleep problems.
- Paresthesias.
- Tremor.
- Extrapyramidal disorders.
Genito-urinary system and reproductive organs:
- Failure of the menstrual cycle.
- Frequent urge to urinate.
- Erectile dysfunction.
- Gynecomastia.
Negative manifestations from other organs and systems:
- Skin rashes.
- Pigmentation of the skin.
- Alopecia.
- Bronchoconstriction.
- Quincke's edema.
- The appearance of hematomas.
- Muscle soreness, myalgia.
Side effects may also occur when taken with other drugs.
Interaction with other drugs
Drugs, together with which the influence of "Verapamil" is enhanced:
- Neuroleptics.
- Tricyclic antidepressants.
Medications that increase the concentration of the active substance in plasma:
- "Cimetidine".
- Ritonavir.
- Indinavir.
The combination of the following medicines with Verapamil increasesnegative manifestations of the heart and blood vessels:
- Inhalation anesthetics.
- Beta-adrenergic blockers.
- Radiocontrast media.
- Blockers of neuromuscular transmission.
- "Flecainide" (antiarrhythmic drug).
The combined use of the above drugs is possible only under the strict supervision of a doctor.
"Verapamil" increases the impact on the body:
- antihypertensive drugs;
- drugs to relax muscle fibers.
Plasma concentrations of the following substances increase significantly when used together with Verapamil:
- Cyclosporin.
- Carbamazepine.
- Tacrolimus.
- Colchicine.
- Serotonin receptor inhibitors.
- Macrolides.
- Cardiac glycosides.
Dose adjustments are needed in these combinations.
The therapeutic effect of "Verapamil" weakens when used together:
- with calcium;
- cholecalciferol;
- inducers of microsomal liver enzymes.
Verapamil slows elimination:
- Propranolol;
- "Phenobarbital";
- Metoprolol;
- Rifampicin.
You can not use "Verapamil" together:
- with class 1-3 antiarrhythmics;
- "Disopyramide".
The use of these drugs is possible only 48 hours after taking Verapamil.
Together with "Quinidine" the patient maygreatly lower blood pressure.
Dose adjustment of Simvastatin is required when used together with Verapamil.
Changes in pharmacokinetic parameters are possible while taking drugs that are highly bound to plasma proteins.
Grapefruit juice increases the absorption of "Verapamil" into the systemic circulation.
Intensifies the negative effect of alcohol on the body, so it is better to avoid it during the treatment period.
It is worth paying attention to the side effects characteristic of Verapamil when taking other medicines with it.
Drug overdose symptoms and treatment
It is necessary to describe the symptoms of an overdose of Verapamil:
- Heart failure.
- Significant reduction in blood pressure.
- Asystole.
- Atrioventricular block.
In case of severe manifestations, it is recommended to perform the following actions:
- Stomach lavage.
- Take enterosorbents.
- Laxatives.
- Control breathing, pulse, ECG and blood pressure.
- Prescribe inotropic drugs at the discretion of the physician.
Possible use of pacemakers. Hemodialysis with an overdose of "Verapamil" is not effective.
Analogues of the drug
The drug is not always suitable due to the composition of the auxiliary components. It is very important to study the instructions from Verapamil. Analogues have a similaraction. These include:
- Ryodipin.
- "Amlodipine".
- Gallopamil.
- Nifedipine.
- Retard.
- Nimodipine
A similar active ingredient has:
- Caveril.
- Finoptin.
- Lekoptin.
- Isoptin.
It is necessary to discuss the effective drug "Verapamil" with the doctor. The use of analogues also requires a doctor's consultation.
Reviews about the drug
This drug is often prescribed for high blood pressure and arrhythmia. Has good "Verapamil" reviews. Analogues are required infrequently. It has a good effect on the cardiac system, normalizes blood pressure, helps with angina pectoris. It is worth noting that some patients note the manifestation of side effects when taking Verapamil. Reviews speak of a possible violation of the stool and nausea, palpitations and dizziness. Several reviews contain information about headaches and sleep disturbance.
Many patients find the drug very effective and take it for a long time. This is how angina attacks pass, blood pressure rises less often. Also note the affordable cost of "Verapamil". Reviews of drug analogues say that they are more expensive.
Some patients did not feel the therapeutic effect when taking the pills. The introduction of the drug intravenously well normalizes blood pressure and heart rate. Often for people with very high blood pressure, repeated administration of the drug "Verapamil" is required. Instructions, reviews note this, contains the recommended dosage, so you need to consult a doctor before taking the remedy.
If there are problems with the liver and kidneys, it is better not to prescribe the drug and find a replacement for it. Pregnant women can take a drug to reduce the tone of the uterus and with tachycardia. The use of "Verapamil", patient reviews confirm this, it will be effective if the drug is prescribed by a doctor after a complete examination. The heart rhythm normalizes, the child becomes calmer. Some patients felt weak and dizzy when taking the pills. In this case, you should cancel the remedy and find a replacement.
It is worth noting that you do not need to start taking the drug yourself without consulting a doctor. Side effects of "Verapamil" and contraindications should be studied and taken into account. Its effect depends on it.
