Verig
Generic Name
Verapamil Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| verig 25 mg tablet | ৳ 30.00 | ৳ 300.00 |
Description
Overview of the medicine
Verapamil is a calcium channel blocker used to treat high blood pressure, angina, and certain heart rhythm disorders by relaxing blood vessels and slowing the heart rate.
Uses & Indications
Dosage
Adults
For hypertension, initial dose of 80 mg three times daily for immediate-release tablets, adjusted based on response. 25 mg is generally a low dose, often used for initial treatment or mild conditions.
Elderly
Lower initial doses and slower titration are recommended due to increased sensitivity and potential for adverse effects.
Renal_impairment
No specific dose adjustment for mild to moderate impairment, but close monitoring is required. Severe impairment may necessitate dose reduction.
How to Take
Take orally, usually with food to minimize gastrointestinal upset. Do not crush or chew extended-release forms; swallow them whole.
Mechanism of Action
Inhibits calcium ion influx into cardiac and vascular smooth muscle cells, leading to peripheral vasodilation, decreased myocardial contractility, and reduced heart rate and AV nodal conduction.
Pharmacokinetics
Onset
Oral: 1-2 hours
Excretion
Approximately 70% renally excreted, 16% fecally excreted.
Half life
3-7 hours (single dose), 4.5-12 hours (multiple doses)
Absorption
Well absorbed orally (90-95%), but extensive first-pass metabolism results in 20-35% bioavailability.
Metabolism
Extensively metabolized in the liver (CYP3A4) to active (norverapamil) and inactive metabolites.
Side Effects
Contraindications
- Severe left ventricular dysfunction
- Hypotension (systolic BP < 90 mmHg)
- Cardiogenic shock
- Sick sinus syndrome (without a pacemaker)
- 2nd or 3rd degree AV block (without a pacemaker)
- Wolff-Parkinson-White syndrome with atrial flutter/fibrillation
Drug Interactions
Digoxin
Verapamil can increase digoxin serum concentrations, requiring digoxin dose reduction.
Beta-blockers
Increased risk of bradycardia, AV block, and myocardial depression.
Grapefruit juice
Can significantly increase verapamil blood levels.
Statins (e.g., Simvastatin, Lovastatin)
Increases statin levels, increasing risk of myopathy and rhabdomyolysis.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, AV block, asystole, and impaired consciousness. Treatment involves supportive care, IV calcium gluconate, vasopressors, atropine, and glucagon.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs the risk to the fetus. Verapamil is excreted in breast milk; use with caution or consider alternatives during lactation.
Side Effects
Contraindications
- Severe left ventricular dysfunction
- Hypotension (systolic BP < 90 mmHg)
- Cardiogenic shock
- Sick sinus syndrome (without a pacemaker)
- 2nd or 3rd degree AV block (without a pacemaker)
- Wolff-Parkinson-White syndrome with atrial flutter/fibrillation
Drug Interactions
Digoxin
Verapamil can increase digoxin serum concentrations, requiring digoxin dose reduction.
Beta-blockers
Increased risk of bradycardia, AV block, and myocardial depression.
Grapefruit juice
Can significantly increase verapamil blood levels.
Statins (e.g., Simvastatin, Lovastatin)
Increases statin levels, increasing risk of myopathy and rhabdomyolysis.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, bradycardia, AV block, asystole, and impaired consciousness. Treatment involves supportive care, IV calcium gluconate, vasopressors, atropine, and glucagon.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs the risk to the fetus. Verapamil is excreted in breast milk; use with caution or consider alternatives during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years from the manufacturing date when stored under recommended conditions.
Availability
Pharmacies, hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic (patent expired)
WHO Essential Medicine
YesClinical Trials
Verapamil has been extensively studied in numerous clinical trials establishing its efficacy and safety for hypertension, angina, and various arrhythmias. Ongoing research continues to explore its full therapeutic potential.
Lab Monitoring
- Blood pressure
- Heart rate
- Electrocardiogram (ECG)
- Liver function tests (periodically, especially with long-term use)
Doctor Notes
- Careful titration is crucial, especially in elderly patients or those with hepatic/renal impairment.
- Monitor patients for signs of heart failure, significant bradycardia, or AV block.
- Consider drug interactions, particularly with beta-blockers and digoxin.
Patient Guidelines
- Take Verapamil exactly as prescribed by your doctor.
- Do not stop taking Verapamil abruptly without consulting your doctor.
- Report any symptoms like severe dizziness, fainting, swelling, or difficulty breathing to your doctor.
- Avoid grapefruit juice during treatment.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Verapamil may cause dizziness or lightheadedness, especially when starting treatment or increasing dosage. Avoid driving or operating machinery until you know how the medication affects you.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet low in sodium and regular exercise.
- Avoid smoking and limit alcohol intake.
- Manage stress effectively to support blood pressure control.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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