What Are the Uses of Verapamil Gel?

Verapamil hydrochloride sustained-release capsules, 1, angina pectoris: variant angina pectoris, unstable angina pectoris. 2. Essential hypertension. ^[1] .

Verapamil hydrochloride sustained-release capsules, 1, angina pectoris: variant angina pectoris, unstable angina pectoris. 2. Essential hypertension. ^[1] .

Drug Name

Verapamil hydrochloride sustained-release capsules

Hanyu Pinyin

Yan Suan Wei La Pa Mi Huan Shi Jiao Nang

Drug type

Occupational injury medical insurance

Use classification

Selective calcium antagonist

Verapamil hydrochloride sustained-release capsule ingredients

Verapami

Properties of Verapamil Hydrochloride Sustained Release Capsules

This product is a capsule and its contents are light yellow spherical particles.

Indications for Verapamil Hydrochloride Sustained Release Capsules

1. Angina pectoris: variant angina pectoris, unstable angina pectoris.
2. Essential hypertension.

Verapamil hydrochloride sustained-release capsules specifications

180mg

Verapamil hydrochloride sustained-release capsules

1. Angina pectoris: once a day, one capsule each time (180mg).
2. Essential hypertension: once a day (180mg) each time.

Adverse effects of verapamil hydrochloride sustained-release capsules

The cardiovascular effects of this drug may exceed the desired therapeutic effect only when the dose is not adjusted properly or there are specific damages, manifested in bradycardia, decreased blood pressure, and weakened myocardial contractility.
Patients are usually well tolerated. May have constipation; occasional nausea, dizziness or dizziness, headache, flushing, fatigue, nervous breakdown or ankle edema; rare reports of allergic reactions (such as pruritus, erythema, rash) and reversible transaminase and / or alkaline Elevated phosphatase. May cause increased blood prolactin concentration or prolactin. Gingival hyperplasia and male mammary gland development have been reported in very rare long-term treatment cases, but they can usually be reversed after drug withdrawal.

Verapamil hydrochloride sustained-release capsules contraindications

1. Severe left ventricular dysfunction.
2. Hypotension (systolic blood pressure less than 90mmHg) or cardiogenic shock.
3. Sick sinus syndrome (except those with pacemakers installed and functioning).
4. or degree atrioventricular block (except for patients who have installed and functioning pacemakers).
5. Atrial flutter or atrial fibrillation patients with atrioventricular bypass channel.
6. Patients known to be allergic to verapamil hydrochloride.

Precautions for Verapamil Hydrochloride Sustained Release Capsules

Heart failure: Verapamil's negative muscular effect can reduce the afterload (reducing the circulatory vascular resistance) and the net compensation effect does not damage the ventricular function. However, patients with severe left ventricular dysfunction (pulmonary wedge pressure greater than 20 mmHg or ejection fraction less than 30%), patients with moderate to severe heart failure, and patients with any degree of ventricular dysfunction who have been treated with beta blockers should avoid the use of vitamin D Rapami. Patients with mild heart failure who must use verapamil must have digitalis or diuretics to control clinical symptoms before treatment.
Pre-excitation syndrome: Verapamil will accelerate forward conduction of atrioventricular bypass. Atrioventricular bypass channels with atrial flutter or atrial fibrillation patients treated with verapamil intravenously, will accelerate the forward conduction of atrioventricular bypass, causing accelerated ventricular rate, and even ventricular fibrillation. Although no such reports have been reported for oral verapamil, such patients may be at risk of receiving oral verapamil and their use is therefore prohibited.
Conduction block: Verapamil may lead to atrioventricular and sinoatrial node block, which is related to the increase of plasma concentration, especially in the early increase period of treatment. Causes first degree atrioventricular block, transient sinus bradycardia, sometimes accompanied by nodular escape. High AV block was uncommon (0.8%). When significant I-degree atrioventricular block appears or gradually progresses to II- or III-degree atrioventricular block, reduction or discontinuation is required.
Hepatic impairment: Verapamil is extensively metabolized in the liver. Patients with impaired liver function should use verapamil with caution. In severe liver dysfunction, the clearance half-life of verapamil is extended to 14-16 hours, and only 30% of the normal dose is needed for this type of patients.
Renal function impairment: Verapamil should be used with caution in patients with impaired renal function. Hemodialysis does not clear verapamil.
Neuromuscular conduction is weakened: Verapamil has been reported to reduce neuromuscular conduction in patients with muscular atrophy, and this type of patients needs to be reduced.
Serum calcium: Verapamil does not change serum calcium concentration, but there are also reports that blood calcium levels above the normal range may affect the efficacy of verapamil.
Because verapamil can increase transaminase, patients who are receiving verapamil should monitor liver function regularly.

Verapamil hydrochloride sustained-release capsules for pregnant and lactating women

Verapamil is available through the placenta. Only for pregnant women who are clearly in need and have no harm to the fetus. Verapamil secretes milk, and breastfeeding should be discontinued while taking Verapamil.

Verapamil hydrochloride sustained-release capsules for children

The safety and efficacy of children under 18 years have not been determined.

Verapamil hydrochloride sustained-release capsules for elderly

The elimination half-life of older patients may be prolonged, and it must be taken into account that liver or renal insufficiency is more common in older patients. Generally, older people use lower starting doses.

Verapamil hydrochloride sustained-release capsules drug interactions

1. Cyclophosphamide, vincristine, methyl benzylhydrazine, prednisone, vinblastine amide, doxorubicin, cisplatin and other cytotoxic drugs reduce the absorption of verapamil.
2. Phenobarbital, vitamin D, sulfazolone and remifen reduce plasma concentration of verapamil by increasing liver metabolism.
3. Cimetidine may increase the bioavailability of verapamil.
4. Verapamil inhibits the elimination of ethanol, leading to an increase in blood ethanol concentration, which may prolong the toxic effect of alcohol.
5. A few cases reported that Verapamil and aspirin were used in combination, and the bleeding time was longer than that when aspirin was used alone.
6. Combined use with -blockers can enhance the inhibition of atrioventricular conduction.
7. Long-term use of verapamil increases the blood concentration of digoxin by 50% to 75%. Verapamil significantly affected the pharmacokinetics of digoxin in patients with liver cirrhosis, reducing total and extrarenal clearance of digoxin by 27% and 29%, respectively. Therefore, when taking verapamil, reduce the dose of digoxin and digitalis.
8. When combined with antihypertensive drugs such as vasodilators, angiotensin-converting enzyme inhibitors, and diuretics, the antihypertensive effect is superimposed, and patients treated with combined antihypertensive therapy should be properly monitored.
9. Combination with amiodarone may increase cardiotoxicity.
10. For patients with hypertrophic cardiomyopathy and aortic stenosis, it is best to avoid combined medication.
11. The combination of verapamil and flucaramide can make the negative muscle force superimpose and prolong the atrioventricular conduction.
12. Verapamil can increase blood concentrations of carbamazepine, cyclosporine, doxorubicin, and theophylline.
13. Verapamil has been reported to increase lithium sensitivity (neurotoxicity) in patients.
14. Animal experiments suggest that when inhaled anesthetics are used with verapamil at the same time, the doses of the two drugs need to be carefully adjusted to avoid excessive inhibition of the heart.
15. Avoid simultaneous use of verapamil and propiramine.

Verapamil hydrochloride sustained-release capsules overdose

The main manifestations of overdose of verapamil are hypotension and bradycardia (e.g. AV separation, high AV block, cardiac arrest), confusion, coma, nausea, vomiting, renal insufficiency, metabolic acid Poisoning and hyperglycemia. Symptomatic treatment includes the application of atropine, isoprenaline and cardiac pacing and intravenous infusions, vasoconstrictors, calcium solutions (such as 10% calcium chloride solution), and positive inotropic drugs. Hemodialysis does not clear verapamil.

Pharmacology and Toxicology of Verapamil Hydrochloride Sustained Release Capsules

Pharmacological effects:
1. Verapamil hydrochloride is a calcium ion antagonist. By regulating the influx of calcium ions on the cell membranes of myocardial conductive cells, myocardial contractile cells and arterial vascular smooth muscle cells, it exerts its pharmacological effect, but does not change the serum calcium concentration.
2. Verapamil hydrochloride dilates coronary arterial trunk and arterioles in normal and ischemic parts of the heart, antagonizes spontaneous or ergometrine-induced coronary spasm, and increases myocardial oxygen delivery, release and prevention in patients with coronary spasm. Coronary arterial spasm; verapamil reduces total peripheral resistance and reduces myocardial oxygen consumption. Can be used to treat variant angina and unstable angina.
3. Verapamil reduces calcium influx, prolongs the effective refractory period of the atrioventricular node, slows conduction, and can slow the ventricular rate of patients with atrial fibrillation and atrial flutter; reduces paroxysmal supraventricular tachycardia Frequency of attacks. Verapamil does not affect normal sinus heart rate, but can lead to sinus arrest or sinoatrial block in patients with sick sinus syndrome. Verapamil does not change the action potential or ventricular conduction time in normal atria, but it decreases The amplitude, velocity, and conduction velocity of the depolarized atrial fiber may shorten the forward effective refractory period of the additional bypass channel, and accelerate the ventricular rate in patients with atrioventricular bypass combined with atrial flutter or atrial fibrillation. Induces ventricular fibrillation.
4. Verapamil reduces blood pressure by reducing vascular resistance in the systemic circulation, and generally does not cause orthostatic hypotension or reflex tachycardia.
5. Verapamil reduces postload, inhibits myocardial contraction, and improves left ventricular diastolic function. Verapamil does not alter the systolic function of patients with normal ventricular function during isometric or dynamic exercise of the myocardium. In patients with organic heart disease, the negative muscle effect of verapamil can be offset by the effect of reducing afterload, and the heart index does not decrease. However, in patients with severe left ventricular dysfunction (such as pulmonary wedge pressure greater than 20mmHg or ejection fraction less than 30%), or patients taking beta blockers or other myocardial inhibitory drugs, cardiac function may deteriorate.
6. Animal tests suggest that verapamil has a local anesthetic effect that is 1.6 times that of procaine. The effect and dosage in humans are unknown.
Carcinogenic, mutagenic and reproductive toxicity:
Verapamil is not carcinogenic. Ames test confirmed that Verapamil is not mutagenic. Beagle dogs taking verapamil 30mg / Kg / d for a long period of time will cause lenticular and / or suture-like changes. 62.5mg / Kg / d will cause obvious cataracts. Humans have not reported any cataract formation due to verapamil. Female rats showed no damage to fertility. The effect on human fertility is unknown.

Pharmacokinetics of Verapamil Hydrochloride Sustained Release Capsules

More than 90% are absorbed after oral administration, and only 20-35% enter the blood circulation after the first-pass effect of the liver. The effect begins 1-2 hours after oral administration. The peak time is about 3-4 hours, and the half-life is 6-8 hours. Protein binding The rate is 90%. It is mainly metabolized in the liver and eliminated mainly by the kidneys. Metabolites are excreted in 50% in 24 hours, 70% in 5 days, 3% in the original drug, and about 9-16% eliminated by the digestive tract with feces. Hemodialysis cannot eliminate this product.

Storage of verapamil hydrochloride sustained-release capsules

Airtight

Verapamil hydrochloride sustained-release capsules

Aluminum plastic packaging, 10 capsules per box

Verapamil hydrochloride sustained-release capsules

Three years