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Verelan
Verelan (generic name: verapamil hydrochloride) is a calcium channel blocker used to treat high blood pressure (hypertension), angina (chest pain), and certain types of arrhythmias such as supraventricular tachycardia and atrial fibrillation. By relaxing blood vessels and reducing the workload on the heart, Verelan helps lower blood pressure and manage abnormal heart rhythms. Verelan is available in extended-release formulations for once-daily dosing.
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Frequently Asked Questions
How long does it take for Verelan to start working?
Verelan starts working within a few hours of the first dose, but the full effect on blood pressure may take a few days to become noticeable.
Can Verelan cause weight gain?
Verelan does not typically cause weight gain, but it can lead to swelling in the feet or ankles, which can be mistaken for weight gain. If you notice significant swelling, contact your healthcare provider.
Can I take Verelan with other blood pressure medications?
Yes, Verelan can be taken with other blood pressure medications, but caution is needed when combining it with beta-blockers or digoxin, as these combinations can increase the risk of bradycardia and other side effects.
What should I do if I miss a dose of Verelan?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses to make up for a missed dose.
Is Verelan safe for long-term use?
Yes, Verelan is designed for long-term management of hypertension, angina, and arrhythmias. Regular monitoring by your healthcare provider will ensure that the medication continues to be effective and safe.
Comprehensive Drug Guide
How Does Verelan Work?
Verelan works by inhibiting the influx of calcium ions into the heart and blood vessel walls. This leads to the relaxation of blood vessels (vasodilation), lowering blood pressure and reducing the heart's oxygen demand. Additionally, Verelan slows the heart rate and helps control abnormal heart rhythms by affecting the electrical conduction system of the heart.
Common Dosages
- 120 mg
- 180 mg
- 240 mg
- 360 mg
Typical Dosing
- For hypertension: The usual starting dose is 180 mg to 240 mg once daily, with the dose adjusted based on the patient's response. The maximum dose can reach 480 mg per day.
- For angina: The starting dose is typically 120 mg to 240 mg once daily, depending on the severity of the condition.
- For arrhythmias: The dose may start at 120 mg to 240 mg once daily, with adjustments as needed.
Typical Dosing
FDA Approved Indications
- Hypertension (high blood pressure)
- Angina (chronic stable and vasospastic angina)
- Arrhythmias (including atrial fibrillation and supraventricular tachycardia)
Who Shouldn't Take Verelan?
- Severe hypotension (low blood pressure)
- Sick sinus syndrome or AV block (without a pacemaker)
- Severe heart failure
- Known hypersensitivity to verapamil or any components of the formulation
- Cardiogenic shock
Advice From The Pharmacist
- Take Verelan once daily, preferably with food, to minimize gastrointestinal upset. Swallow the capsules whole, and do not crush or chew them, as this may interfere with the time-release mechanism.
- Avoid grapefruit and grapefruit juice, as they can increase the levels of verapamil in your blood and raise the risk of side effects.
- Monitor your blood pressure regularly while taking Verelan to ensure that it effectively controls your hypertension.
- Do not stop Verelan suddenly without consulting your doctor, especially if you are using it for arrhythmias or angina, as this could lead to a worsening of symptoms.
Side Effects of Verelan
Common Side Effects
- Constipation
- Dizziness
- Headache
- Fatigue
- Swelling in the ankles or feet
Uncommon/Severe Side Effects
- Bradycardia (slow heart rate)
- Severe hypotension
- Heart failure (worsening of symptoms)
- Severe allergic reactions (rash, swelling, difficulty breathing)
Risks and Warnings of Verelan
- Bradycardia and Hypotension: Verelan can cause significant slowing of the heart rate and low blood pressure, especially in patients taking other heart medications such as beta-blockers. Regular monitoring of heart rate and blood pressure is recommended.
- Worsening Heart Failure: Verapamil can exacerbate symptoms of heart failure, particularly in patients with preexisting conditions. It should be used cautiously in patients with heart failure.
- Constipation: Constipation is a common side effect of Verelan. Increasing fiber intake, staying hydrated, and exercising can help alleviate this issue.
Interactions with Verelan
Common Drug Interactions
- Grapefruit juice: Grapefruit juice can increase the levels of Verelan in the blood, increasing the risk of side effects such as low blood pressure and slow heart rate. Avoid grapefruit products while taking Verelan.
- Beta-blockers (e.g., metoprolol, atenolol): Combining Verelan with beta-blockers can increase the risk of bradycardia (slow heart rate) and heart block.
- Digoxin: Verelan can increase digoxin levels in the blood, potentially leading to digoxin toxicity. Regular monitoring of digoxin levels may be necessary.
- Statins (e.g., simvastatin, atorvastatin): Verelan can increase the risk of muscle pain or weakness when used with statins.
Alternatives to Verelan
- Amlodipine (Norvasc): A dihydropyridine calcium channel blocker used for hypertension and angina, with fewer heart rate effects.
- Diltiazem (Cardizem): Another non-dihydropyridine calcium channel blocker used for hypertension, angina, and arrhythmias.
- Beta-blockers (e.g., metoprolol, propranolol): Often used for treating hypertension, angina, and arrhythmias, working by reducing the workload on the heart.
