{"id":2276,"date":"2023-06-25T17:55:36","date_gmt":"2023-06-25T17:55:36","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/verapamil-hydrochloride\/"},"modified":"2023-06-25T18:01:39","modified_gmt":"2023-06-25T18:01:39","slug":"verapamil-hydrochloride","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/verapamil-hydrochloride\/","title":{"rendered":"verapamil hydrochloride"},"content":{"rendered":"

<\/p>\n

CLINICAL USE<\/h3>\n

Calcium-channel blocker: Supraventricular arrhythmias Angina Hypertension<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

Oral: Supraventricular arrhythmias: 40\u2013120 mg 3 times daily Angina: 80\u2013120 mg 3 times daily Hypertension: 240\u2013480 mg daily in 2\u20133 divided doses IV: 5\u201310 mg followed by 5 mg, 5\u201310 minutes later if required<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           : 491.1<\/li>\n
  • %Protein binding                           : 90<\/li>\n
  • %Excreted unchanged in urine     : <4<\/li>\n
  • Volume of distribution (L\/kg)       : 3\u20136<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      : 4.5\u201312\/Increased
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function. Monitor carefully<\/li>\n
  • 10 to 20     : Dose as in normal renal function. Monitor carefully<\/li>\n
  • <10           : Dose as in normal renal function. Monitor carefully
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                : Not dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HD                     : Not dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HDF\/high flux   : Unknown dialysability. Dose as in GFR <10 mL\/min<\/li>\n
  • CAV\/VVHD      : Dialysability minimal. Dose as in GFR 10 to 20 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Anaesthetics: increased hypotensive effect<\/li>\n
  • Anti-arrhythmics: increased risk of amiodarone-induced bradycardia, AV block and myocardial depression; increased risk of myocardial depression and asystole with disopyramide and flecainide<\/li>\n
  • Antibacterials: metabolism increased by rifampicin; metabolism possibly inhibited by erythromycin and clarithromycin (increased risk of toxicity)<\/li>\n
  • Anti-epileptics: effect probably reduced by barbiturates, phenytoin and primidone; enhanced effect of carbamazepine Antihypertensives: enhanced hypotensive effect, increased risk of first dose hypotensive effect of post-synaptic alpha- blockers<\/li>\n
  • Antivirals: concentration possibly increased by atazanavir and ritonavir<\/li>\n
  • Beta-blockers: enhanced hypotensive effect; risk of asystole, severe hypotension and heart failure if co-prescribed with beta-blockers Cardiac glycosides: increased levels of digoxin. Increased AV block and bradycardia<\/li>\n
  • Ciclosporin: variable reports of decreased nephrotoxicity and potentiated effect; may also increase ciclosporin levels<\/li>\n
  • Grapefruit juice: concentration increased \u2013 avoid concomitant use Ivabradine: avoid concomitant use Sirolimus: concentration of both drugs increased Statins: increased myopathy with simvastatin \u2013 do not exceed 20 mg of simvastatin.1<\/li>\n
  • Tacrolimus: may increase tacrolimus levels Theophylline: enhanced effect of theophylline Verapamil hydrochloride .
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral, IV<\/p>\n

    Rate of Administration<\/h4>\n

    Over 2 minutes (3 minutes in elderly)<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n

    Monitor BP and ECG Active metabolites may accumulate in renal impairment<\/li>\n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Calcium-channel blocker: Supraventricular arrhythmias Angina Hypertension DOSE IN<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-2276","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2276","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=2276"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2276\/revisions"}],"predecessor-version":[{"id":2311,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2276\/revisions\/2311"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=2276"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=2276"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=2276"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}