Veramil

Country of origin: India
Pharm-Group: Calcium channel blockers of the phenylalkylamine group

Manufacturers: Temis Chemicals Ltd (India)
International name: Verapamil
Synonyms: Atsupamil, Vepamil, Veracard, Verapabene, Verapamil, Verapamil (Mival), Verapamil hydrochloride, Verapamil-MIK, Verapamil-Ratiopharm, Verapamil hydrochloride, Vero-Verapamil, Verogalid ER, Veromil, Danistol, Isoptin, Isoptin SR, Kaveril, Lekoptin , Falicard, Fa
Dosage forms: film-coated tablets 40 mg, film-coated tablets 80 mg
Composition: Active ingredient - Verapamil.

Indications for use: Paroxysmal supraventricular tachycardia (except WPW syndrome), sinus tachycardia, atrial extrasystole, atrial fibrillation and flutter, angina pectoris (including Prinzmetal, tension, post-infarction), arterial hypertension, hypertensive crisis, idiopathic hypertrophic subaortic stenosis, hypertrophic cardiomyopathy.

Contraindications: Hypersensitivity, severe hypotension, cardiogenic shock, AV block II and III degrees, myocardial infarction (acute or recent and complicated by bradycardia, hypotension, left ventricular failure), chronic heart failure stage III, WPW syndrome and sick sinus syndrome ( if a pacemaker is not implanted), sinoatrial block, Morgagni-Adams-Stokes syndrome, digitalis intoxication, severe aortic stenosis, pregnancy, breastfeeding. Restrictions on use: AV blockade of the first degree, chronic heart failure of stages I and II, severe bradycardia (less than 50 beats/min), mild or moderate hypotension, severe myopathy (Duchenne syndrome), impaired liver or kidney function, ventricular tachycardia with wide QRS complex (for intravenous administration).

Side effect:

1. From the cardiovascular system and blood (hematopoiesis, hemostasis): hypotension, bradycardia (sinus), AV block, heart failure.
2. From the nervous system and sensory organs: headache, dizziness, nervousness, lethargy, drowsiness, weakness, fatigue, paresthesia.
3. From the gastrointestinal tract: nausea, dyspeptic symptoms, constipation rarely - gingival hyperplasia, increased activity of liver transaminases, alkaline phosphatase.
4. Allergic reactions: skin rash, urticaria, itching rarely - angioedema, Stevens-Johnson syndrome.
5. Other: facial skin flushing, bronchospasm (with intravenous administration), peripheral edema, very rarely - gynecomastia, increased prolactin secretion (isolated cases).

Interaction:

1. Increases plasma levels of digoxin, cyclosporine, theophylline, carbamazepine, decreases lithium.
2. Weakens the antibacterial activity of rifampicin, the depressing effect of phenobarbital, the clearance of metoprolol and propranolol, and enhances the effect of muscle relaxants.
3. Rifampicin, sulfinpyrazone, phenobarbital, calcium salts, vitamin D - weaken the effect.
4. The hypotensive effect is enhanced by antihypertensive drugs (diuretics, vasodilators), tricyclic and tetracyclic antidepressants and antipsychotics: antianginal - nitrates.
5. Beta-blockers, class IA antiarrhythmics, cardiac glycosides, inhalational anesthetics, and radiopaque agents potentiate a (mutually) inhibitory effect on the automatism of the sinoatrial node, AV conduction and myocardial contractility.
6. When used simultaneously with acetylsalicylic acid, existing bleeding may increase.
7. Cimetidine increases the plasma levels of verapamil.
8. The injection form is incompatible with albumin, injection forms of amphotericin B, hydralase