Active material: Verapamil
When ATH: C08DA01
CCF: Kalьcievыh channel blocker
When CSF: 01.03.01
Manufacturer: ORION CORPORATION (Finland)

Pharmaceutical form, composition and packaging

Pills, coated1 tab.
verapamil hydrochloride40 mg

30 PC. – plastic bottles (1) – packs cardboard.
100 PC. – plastic bottles (1) – packs cardboard.

Pills, coated1 tab.
verapamil hydrochloride80 mg

30 PC. – plastic bottles (1) – packs cardboard.
100 PC. – plastic bottles (1) – packs cardboard.


Pharmacological action

BMKK (inhibits the transmembrane transport of Ca2 + to the DSA fibres smooth muscle cells), derivative difenilalkilamina. Has is an antianginal, antriaritmicheskim and gipotenzive effect. Antianginal effect is associated with both the direct effect on the myocardium, and the effect on peripheral hemodynamics (It lowers the tone of the peripheral arteries, PR). Embargo proceeds Ca2 + into the cell reduces the transformation done in makroergicheskih links ATF energy into mechanical work, reduce myocardial contractility. It reduces myocardial oxygen demand, It has a vasodilatory, negative Eno- and chronotropism. Significantly reduces the AV conduction, lengthens the period previously and suppresses automaticity sinusnogo hub. Increases the period of diastolic relaxation LV, reduces myocardial wall tone (is an auxiliary treatment for GOKMP). It is possible to use as HP for prevention of headaches vascular Genesis: inhibits vasoconstriction, arising in dormant mode period, blockade of Ca2 +-channels can weaken or prevent Jet expansion vessels. Inhibits metabolism with cytochrome P450. The on/bolusnom activity begins almost immediately after the introduction (1-5 m), maximal effect develops after 3-5 minutes after the on/in the introduction, and continues 10-20 m – hemodynamic effects and 2 no – antiaritmicski. Beginning of the ingestion effect – through 1-2 no, maximal effect develops after 30-90 m (typically for 24-48 no), duration of effect – 8-10 h for the usual oral forms and 24 no – for prolonged. Antianginalny effect is dose-dependent nature, tolerance does not occur.



Angina (voltage, stable without vasoconstriction, stable vasospastic), supraventricular tachycardia (incl. paroksizmalynaya, when WPW-syndrome, Lown-Ganong syndrome-Levine), sinus tachycardia, atrial tachyarrhythmia, auricular flutter, Atrial premature beats, arterial hypertension, hypertensive crisis (in / introduction), GOKMP, primary hypertension in “small” circle of blood circulation.



Hypersensitivity, severe hypotension, AV blockade II-III century., SA blockade and SSSU (except for patients with a pacemaker), WPW-syndrome or Lown-Ganong-Levine in conjunction with flutter or atrial fibrillation (except for patients with a pacemaker), pregnancy, lactation. AV blockade of the 1st century., bradycardia, severe aortic stenosis, CHF, mild or moderate arterial hypertension, myocardial infarction with left ventricular failure, liver and / or kidney failure, advanced age, Age to 18 years (efficacy and safety have not been studied).


Side effects

From the CCC: bradycardia (less than 50/min), marked reduction in blood pressure, development or exacerbation of heart failure, tachycardia; rarely – angina, until the development of myocardial infarction (especially in patients with severe obstructive coronary artery disease), arrhythmia (incl. flicker and flutter); With the rapid on / in a – AV blockade III art., asistolija, collapse. From the nervous system: dizziness, headache, fainting, anxiety, lethargy, fatigue, asthenia, drowsiness, depression, extrapyramidal disorders (ataxia, mask-like face, shuffling gait, stiffness in the arms or legs, shaking hands and fingers, difficulty weight management). From the digestive system: nausea, constipation (rarely – diarrhea), giperplaziya right (angiostaxis, soreness, puffiness), increased appetite, activity increase “Hepatic” transaminases and alkaline phosphatase. Allergic reactions: itching, skin rash, facial flushing, erythema multiforme exudative (incl. Stevens-Johnson syndrome). Other: weight gain, rarely – agranulocytosis, gynecomastia, hyperprolactinemia, galactorrhea, arthritis, transient vision loss amid Cmax, pulmonary edema, thrombocytopenia bessimptomnaya, peripheral oedema. Overdose. Symptoms: bradycardia, OF блокада, marked reduction in blood pressure, SN, shock, asistolija, SA blockade. Treatment: When early identification – gastric lavage, Activated carbon; If there is a violation of rhythm and conduction – in/in isoprenaline, norepinephrine, atropyn, 10-20 ml 10% solution of calcium gluconate, artificial pacemaker; in/in cefuroxim plasma substitutional solutions. To raise HELL in patients prescribed Alpha-GOKMP adrenostimuljatory (Phenylephrine); do not apply the isoprenaline and norapinefrin. Hemodialysis nyeeffyektivyen.


Dosing and Administration

Inside, by 40-80 mg 3 once a day (for dosage forms of normal duration) – in Angina Pectoris and supraventricular tachycardia in 3 admission, with hypertension – in 2 admission, daily dose in hypertension – to 480 mg, at GOKMP – to 720 mg. Children with hypertension – 10 mg / kg / day (in divided doses), with supraventricular arrhythmias (to 2 years) – by 20 mg 2-3 once a day. Daily dose of Verapamil to children under 5 years – 40-60 mg; for children 6 to 14 years – 80-360 mg (for 3-4 admission). For prolonged forms dose should be selected individually depending on the severity of the disease. In arterial hypertension in adults – 240 mg in the morning. If you need a slow reduction of the HELL the recommended initial dose is 120 mg 1 once a day in the morning. The dose should be carried out after 2 weeks dose. The dose to 480 mg / day (by 1 Tablet morning and evening, interval around 12 hours between meals). With long-term therapy daily dose should not exceed 480 mg. Overdose is possible only for a very short time under careful medical supervision. Pills, drop, take capsules, not liquid and rassasavaya, drinking a small amount of liquid, preferably before meal or after meal. For edema paroxysmal rhythm disorders or gipertoniceski kriza injected (the contents of the ampoule is diluted 0.9% NaCl solution) w / jet, slowly (during 2-5 min speeds 5 ug / kg / min) dose 5-10 mg under the supervision of ad, Heart rate and ECG. In the absence of the effect of possible re-introduction 20-30 mines in the same dose. As a maintenance therapy possible in/in drip introduction (infusion solution are based 5 mg Verapamil on 150 ml 0.9% NaCl solution, 5% solution dekstrozy or ringer's solution). Single-dose Verapamil for infants with on/in the introduction – 0.75-2 mg, for children 1-5 years – 2-3 mg, for children 6-14 years – 2.5-3.5 mg. In hypertensive crisis children first – / drip, with speed 0.05-0.1 mg / kg / hr. If this dose is insufficient, through 30-60 min dose. Average daily dose – 1.5 mg / kg. For patients with severe hepatic insufficiency daily dose should not exceed 120 mg.



You must compensate for heart failure. During treatment needed to be monitored functions SSS, the respiratory system, for glucose and electrolytes in the blood, Bcc and amount of urine. In newborns and infants experienced severe hemodynamic effects. Can lengthen the interval P-Q when plasma concentrations above 30 ng / ml. It is not recommended that you stop treatment suddenly.



Increases concentration in the blood of Digoxin, teofillina, prazosin, cyclosporine, karʙamazepina, muscle relaxants, xinidina, valproeva acid due to oppression metabolism with cytochrome P450. Zimetidin increases bioavailability verapamila almost 40-50% (by reducing liver metabolism), Therefore, you might need to reduce the dose of the last. Drugs Ca2 + reduces the efficacy of Verapamil. Rifampicin, barbiturates, nicotine, accelerating the metabolism in the liver, reduce the concentration in the blood Verapamil, reduces the pronounced antianginalnogo, hypotensive and anti-arrhythmic action. Together with the use of inhalants anaesthetics increased risk of bradycardia, AV blockade, SN. Prokaynamyd, quinidine, etc. PM, causing elongation of the Q-T interval, increase the risk of its significant elongation. Combination with beta-adrenoblokatorami may exacerbate the negative effect of inotropnogo, increased risk of development of AV conduction, ʙradikardii (introduction of Verapamil and beta-adrenoblokatorov, you must carry out every few hours). Prazosin, etc. Alfa-adrenoblokatora increase gipotenzivny effect. NSAIDS reduce gipotenzivny effect due to suppression of Pg synthesis, delay of Na + and fluid in the body. Increases concentration of cardiac glycosides (requires careful monitoring and dose reduction glycosides). Simpatomimetiki reduce gipotenzivny effect of Verapamil. Dizopiramid and flecainide should not be administered during 48 hours prior to or 24 hours after the use of Verapamil (summation of a negative inotropnogo effect, until death). Estrogens reduce gipotenzivny effect due to fluid retention in the body. May increase plasma concentrations of PP, characterized by a high degree of binding to proteins (incl. coumarin derivatives and indandiona, NSAIDs, xinina, salitsilatov, sulifinpirazona). PM, reduce the HELL, gipotenzivny effect of Verapamil. Increases the risk of neurotoxic effect of preparations of Li +. Enhances the activity of peripheral muscle relaxant (may require changes in dosage).

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