{"id":4717,"date":"2025-03-31T18:12:17","date_gmt":"2025-03-31T18:12:17","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/verapamil-hydrochloride-txt\/"},"modified":"2025-03-31T18:12:17","modified_gmt":"2025-03-31T18:12:17","slug":"verapamil-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/verapamil-hydrochloride-txt\/","title":{"rendered":"verapamil hydrochloride.txt"},"content":{"rendered":"

CLINICAL USE <\/H3> Calcium-channel blocker: Supraventricular arrhythmias Angina Hypertension

DOSE IN NORMAL RENAL FUNCTION <\/H3> 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

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 491.1 <\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 90 <\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : <4 <\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp : 3\u20136 <\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp : 4.5\u201312\/Increased

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function. Monitor carefully
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function. Monitor carefully
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function. Monitor carefully

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Not dialysed. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp : Unknown dialysability. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp: Dialysability minimal. Dose as in GFR 10 to 20 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3> Potentially hazardous interactions with other drugs\n
  • Anaesthetics: increased hypotensive effect\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\n
  • Antibacterials: metabolism increased by rifampicin; metabolism possibly inhibited by erythromycin and clarithromycin (increased risk of toxicity)\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\n
  • Antivirals: concentration possibly increased by atazanavir and ritonavir\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\n
  • Ciclosporin: variable reports of decreased nephrotoxicity and potentiated effect; may also increase ciclosporin levels\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\n
  • Tacrolimus: may increase tacrolimus levels Theophylline: enhanced effect of theophylline Verapamil hydrochloride .

    ADMINISTRATION <\/H3>

    Reconstition<\/H4> \u2013

    Route <\/H4> Oral, IV

    Rate of Administration <\/H4> Over 2 minutes (3 minutes in elderly)

    Comments<\/H4> \u2013

    OTHER INFORMATION <\/H4> Monitor BP and ECG Active metabolites may accumulate in renal impairment
    \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":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4717","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\/4717","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=4717"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4717\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4717"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4717"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4717"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}