section name header

Pronunciation

ver-AP-a-mil

Classifications

Therapeutic Classification: antianginals, antiarrhythmics (class IV), antihypertensives, vascular headache suppressants

Pharmacologic Classification: calcium channel blockers

Indications

REMS

Unlabeled Uses:

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: 90% absorbed after oral administration, but much is rapidly metabolized, resulting in bioavailability of 20–25%.

Distribution: Well distributed to tissues.

Protein Binding: 90%.

Metabolism/Excretion: Primarily metabolized by the liver via the CYP3A4 isoenzyme. Primarily excreted in urine (4% as unchanged drug).

Half-life: 4.5–12 hr.

Time/Action Profile

(cardiovascular effects)

ROUTEONSETPEAKDURATION
PO1–2 hr30–90 min3–7 hr
PO-extended releaseunknown5–7 hr24 hr
IV1–5 min3–5 min2 hr

†Single dose; effects from multiple doses may not be evident for 24–48 hr.

†Antiarrhythmic effects; hemodynamic effects begin 3–5 min after injection and persist for 10–20 min.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: ARRHYTHMIAS, bradycardia, chest pain, HF, hypotension, palpitations, peripheral edema, syncope, tachycardia.

Derm: dermatitis, erythema multiforme, flushing, photosensitivity, pruritus/urticaria, rash, STEVENS-JOHNSON SYNDROME (SJS), sweating.

EENT: blurred vision, disturbed equilibrium, epistaxis, tinnitus.

Endo: gynecomastia, hyperglycemia.

GI: liver enzymes, anorexia, constipation, diarrhea, dry mouth, dyspepsia, nausea, vomiting.

GU: dysuria, nocturia, polyuria, sexual dysfunction, urinary frequency.

Hemat: anemia, leukopenia, thrombocytopenia.

Metab: weight gain.

MS: joint stiffness, muscle cramps.

Neuro: abnormal dreams, anxiety, confusion, dizziness/lightheadedness, drowsiness, dysgeusia, extrapyramidal reactions, headache, jitteriness, nervousness, paresthesia, psychiatric disturbances, tremor, weakness.

Resp: cough, dyspnea.
Misc: gingival hyperplasia.

Interactions

Drug-Drug:

Drug-Natural Products:

Drug-Food:

Route/Dosage

see Calculator

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Calan, Calan SR, Verelan, Verelan PM

Canadian Brand Names

Isoptin SR