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Verelan PM
Verelan PM (verapamil hydrochloride) is a calcium channel blocker used to treat high blood pressure (hypertension) and certain types of angina (chest pain). It works by relaxing blood vessels, improving blood flow, and reducing the heart's workload. Verelan PM is designed for once-daily dosing and provides extended-release effects, which help maintain stable blood pressure control throughout the day and night.
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Frequently Asked Questions
How long does it take for Verelan PM to start working?
Verelan PM starts working within a few hours after taking the dose at bedtime, providing continuous control of blood pressure throughout the following day.
Can Verelan PM cause weight gain?
Verelan PM does not typically cause weight gain, but it can lead to swelling in the feet or ankles, which may be mistaken for weight gain. Contact your healthcare provider if you notice significant swelling.
Can I take Verelan PM with other blood pressure medications?
Yes, Verelan PM is often used with other antihypertensive medications, but caution is needed when combining it with beta-blockers or digoxin, as these combinations can increase the risk of side effects such as bradycardia (slow heart rate).
What should I do if I miss a dose of Verelan PM?
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 PM safe for long-term use?
Yes, Verelan PM is designed for long-term management of hypertension, angina, and arrhythmias. Regular monitoring by your healthcare provider will ensure that the medication remains effective and safe.
Comprehensive Drug Guide
How Does Verelan PM Work?
Verelan PM works by inhibiting the influx of calcium ions into the smooth muscle of blood vessels and the heart. This leads to the relaxation of blood vessels, a reduction in blood pressure, and decreased heart rate. By lowering blood pressure and reducing the heart's workload, Verelan PM helps prevent angina, hypertension, and heart-related complications.
Common Dosages
- 100 mg, 200 mg, and 300 mg extended-release capsules
Typical Dosing
- For hypertension: The typical starting dose is 200 mg once daily, taken at bedtime. The dose may be adjusted to 300 mg or 400 mg once daily depending on the patient’s response.
- For angina: Dosing is individualized, with most patients starting at 100 mg to 200 mg once daily in the evening.
- For arrhythmias: The dose will vary based on the specific condition, typically starting at 100 mg to 200 mg once daily.
Typical Dosing
FDA Approved Indications
- Hypertension (high blood pressure)
- Angina (chronic stable angina and vasospastic angina)
- Arrhythmias (including atrial fibrillation and supraventricular tachycardia)
Who Shouldn't Take Verelan PM?
- 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 PM once daily at bedtime with or without food. The extended-release formulation provides 24-hour blood pressure control.
- Do not crush or chew the capsules; swallow them whole to preserve the time-release mechanism. If you have difficulty swallowing, some capsules can be opened and the contents sprinkled on a spoonful of applesauce (check with your healthcare provider first).
- Avoid grapefruit and grapefruit juice, as these can increase the levels of verapamil in the blood and increase the risk of side effects.
- Monitor your blood pressure regularly to ensure that Verelan PM is effectively controlling your hypertension.
Side Effects of Verelan PM
Common Side Effects
- Constipation
- Dizziness
- Headache
- Fatigue
- Swelling of 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 PM
- Bradycardia and Hypotension: Verelan PM can cause a significant slowing of the heart rate and low blood pressure, particularly 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 worsen symptoms of heart failure, particularly in individuals with preexisting heart conditions. It should be used with caution in patients with heart failure.
- Constipation: Constipation is a common side effect of Verelan PM. Increasing fiber intake and staying hydrated can help prevent this issue.
Interactions with Verelan PM
Common Drug Interactions
- Grapefruit juice: Grapefruit juice can increase the levels of Verelan PM in the blood, increasing the risk of side effects such as low blood pressure and slow heart rate. Avoid grapefruit products while taking this medication.
- Beta-blockers (e.g., metoprolol, atenolol): Combining Verelan PM with beta-blockers can increase the risk of bradycardia and heart block.
- Digoxin: Verelan PM can increase digoxin levels in the blood, potentially leading to digoxin toxicity.
- Statins (e.g., simvastatin): Verelan PM can increase the risk of muscle pain or weakness when used with statins.
Alternatives to Verelan PM
- Amlodipine (Norvasc): A dihydropyridine calcium channel blocker used to treat hypertension and angina with fewer heart rate effects.
- Diltiazem (Cardizem): A non-dihydropyridine calcium channel blocker similar to verapamil, used for hypertension, angina, and arrhythmias.
- Beta-blockers (e.g., metoprolol, propranolol): These are often used for treating hypertension, angina, and arrhythmias, working by reducing the workload on the heart.
