Verig
Generic Name
Verapamil Hydrochloride
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| verig 5 mg tablet | ৳ 50.00 | ৳ 500.00 |
Description
Overview of the medicine
Verig 5 mg Tablet contains Verapamil Hydrochloride, a calcium channel blocker. It is used to treat high blood pressure, angina (chest pain), and certain types of irregular heartbeats (arrhythmias). While 5 mg is more commonly an intravenous dose, this formulation is an oral tablet for specific therapeutic needs, although less common for typical oral treatment compared to higher strengths.
Uses & Indications
Dosage
Adults
The usual initial oral dose for hypertension or angina is 40-80 mg three times daily, or 120-240 mg once daily for extended-release. A 5 mg tablet is unusual for these indications; consult a physician for specific dosing instructions.
Elderly
Lower initial doses may be appropriate due to increased sensitivity and potential for reduced hepatic clearance. Start with 40 mg two or three times daily or lower, if available.
Renal_impairment
Use with caution. Dosage reduction may be necessary in patients with severe renal impairment. Monitor for adverse effects.
How to Take
Take Verig 5 mg Tablet orally, usually with food or milk to minimize gastrointestinal upset. Do not crush or chew the tablet unless it is specifically designed for such administration. Follow your doctor's instructions carefully.
Mechanism of Action
Verapamil inhibits the influx of extracellular calcium ions across the myocardial and vascular smooth muscle cell membranes. This reduces myocardial contractility, dilates coronary and peripheral arteries, and slows conduction through the AV node, thereby reducing heart rate and blood pressure.
Pharmacokinetics
Onset
Oral: 1-2 hours for antihypertensive effect. IV: 1-5 minutes for antiarrhythmic effect (not applicable for tablet).
Excretion
Approximately 70% excreted in urine, 16% in feces within 5 days. About 3-4% excreted unchanged in urine.
Half life
3-7 hours for single oral dose, 4.5-12 hours for chronic oral dosing.
Absorption
Rapidly and extensively absorbed from the GI tract (90%), but undergoes extensive first-pass metabolism, resulting in 20-35% bioavailability.
Metabolism
Extensively metabolized in the liver via CYP3A4 to several inactive and one active (norverapamil) metabolite.
Side Effects
Contraindications
- Severe left ventricular dysfunction (e.g., ejection fraction less than 30%)
- Hypotension (systolic blood pressure less than 90 mmHg)
- Cardiogenic shock
- Sick sinus syndrome (unless a functional pacemaker is present)
- Second or third-degree AV block (unless a functional pacemaker is present)
- Atrial flutter or atrial fibrillation with an accessory bypass tract (e.g., Wolff-Parkinson-White, Lown-Ganong-Levine syndromes)
Drug Interactions
Digoxin
Verapamil may increase serum digoxin levels. Monitor digoxin levels and adjust dose.
Amiodarone
Increased risk of bradycardia, AV block, and hypotension. Avoid concurrent use if possible.
Dabigatran
Increased risk of bleeding due to increased dabigatran levels. Concomitant use should be avoided or carefully monitored.
Beta-blockers
Increased risk of bradycardia, AV block, and myocardial depression. Use with caution.
Grapefruit juice
May increase verapamil levels. Avoid concurrent use.
Statins (e.g., Simvastatin, Lovastatin)
Verapamil inhibits CYP3A4, increasing statin levels and risk of myopathy. Lower statin dose or choose an alternative.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe hypotension, bradycardia, heart block, and asystole. Treatment is largely supportive, including intravenous calcium, vasopressors, and atropine. Gastric lavage may be considered soon after ingestion. Close monitoring in a hospital setting is crucial.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Verapamil is excreted in breast milk; therefore, exercise caution when administering to a nursing mother. Consult your doctor.
Side Effects
Contraindications
- Severe left ventricular dysfunction (e.g., ejection fraction less than 30%)
- Hypotension (systolic blood pressure less than 90 mmHg)
- Cardiogenic shock
- Sick sinus syndrome (unless a functional pacemaker is present)
- Second or third-degree AV block (unless a functional pacemaker is present)
- Atrial flutter or atrial fibrillation with an accessory bypass tract (e.g., Wolff-Parkinson-White, Lown-Ganong-Levine syndromes)
Drug Interactions
Digoxin
Verapamil may increase serum digoxin levels. Monitor digoxin levels and adjust dose.
Amiodarone
Increased risk of bradycardia, AV block, and hypotension. Avoid concurrent use if possible.
Dabigatran
Increased risk of bleeding due to increased dabigatran levels. Concomitant use should be avoided or carefully monitored.
Beta-blockers
Increased risk of bradycardia, AV block, and myocardial depression. Use with caution.
Grapefruit juice
May increase verapamil levels. Avoid concurrent use.
Statins (e.g., Simvastatin, Lovastatin)
Verapamil inhibits CYP3A4, increasing statin levels and risk of myopathy. Lower statin dose or choose an alternative.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe hypotension, bradycardia, heart block, and asystole. Treatment is largely supportive, including intravenous calcium, vasopressors, and atropine. Gastric lavage may be considered soon after ingestion. Close monitoring in a hospital setting is crucial.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Verapamil is excreted in breast milk; therefore, exercise caution when administering to a nursing mother. Consult your doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date, check product packaging for exact date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory bodies worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Verapamil has been extensively studied in numerous clinical trials for its efficacy in hypertension, angina, and arrhythmias, establishing its role as a standard treatment. Specific trials for a 5 mg oral tablet form would be highly specialized and less common.
Lab Monitoring
- Regular monitoring of blood pressure and heart rate.
- Periodic ECG monitoring, especially in patients with heart conduction abnormalities.
- Liver function tests in patients on long-term therapy or with hepatic impairment.
Doctor Notes
- Educate patients on the importance of adherence, especially for hypertension and angina.
- Caution advised when co-administering with beta-blockers or digoxin due to potential for synergistic negative effects on heart rate and conduction.
- Monitor for signs of heart failure exacerbation, especially in patients with pre-existing left ventricular dysfunction.
Patient Guidelines
- Take your medicine regularly as directed by your doctor, even if you feel well.
- Do not stop taking Verig abruptly, as this may worsen your condition. Consult your doctor first.
- Avoid activities requiring mental alertness, such as driving, until you know how the medicine affects you, as it may cause dizziness.
- Report any unusual symptoms or side effects to your doctor immediately.
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 double the dose to catch up.
Driving Precautions
Verapamil may cause dizziness or lightheadedness, especially when starting treatment or increasing the dose. Avoid driving or operating heavy machinery until you know how the medicine affects you.
Lifestyle Advice
- Adopt a healthy lifestyle, including a balanced diet low in sodium and saturated fats.
- Engage in regular physical activity as advised by your doctor.
- Limit alcohol consumption and avoid smoking.
- Monitor your blood pressure regularly at home if recommended by your doctor.
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Global Brand Names
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