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 Use:

Action ⬆ ⬇

  • Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction.
  • Decreases sinoatrial and atrioventricular nodal conduction and prolongs atrioventricular node refractory period in conduction tissue.
Therapeutic effects:
  • Reduction in BP.
  • Reduction in frequency and severity of angina episodes.
  • Reduction of ventricular rate during atrial fibrillation or atrial flutter.
  • Prevention and/or termination of supraventricular tachycardia.

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 min‡3–7 hr
PO-extended releaseunknown5–7 hr24 hr
IV1–5 min‡3–5 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:

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

IV Administration:

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Calan, Calan SR, Verelan, Verelan PM

Canadian Brand Names ⬆ ⬇

Isoptin SR

Code ⬆

NDC Code