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Last Updated on March 16, 2024

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The active ingredient Verapamil is used in the treatment of cardiac arrhythmias, coronary heart disease and hypertension. They are used mostly in the form of tablets. In some cases, caused Verapamil treatment side effects such as dizziness, headache, facial flushing and swollen ankles. Here you can read everything about Verapamil.

How Verapamil works

In order for the heart muscle regularly can pump blood through the body, its cells must be excited uniformly. This excitation formed between back repeatedly. These processes called ion channels are involved in the cell membranes: Through them flow when energized and when the repolarization certain charged particles (ions) into the cells or out of the cells

At the heart rhythm (arrhythmia) is disturbed this uniform alternation between arousal and regression of excitement: a result, the heart muscle can no longer contract rhythmically – an irregular heart rate is the result. If there is more common to such irregularities, an adequate blood flow to the body is no longer guaranteed. Then may be necessary, treatment with so-called antiarrhythmics (medicines for heart rhythm disturbances).

A representative of antiarrhythmics is the active ingredient Verapamil. It blocks a specific ion channel (calcium channel) and thus inhibits an excessive excitation of the heart muscle. So the beat rate of the heart is normalized.

In addition, there is at heart a vasodilation and thus improved to a blood circulation. This effect is particularly desirable in the case of coronary heart disease, wherein the poor blood circulation of the coronary arteries leads to a reduced oxygen supply to the cells.

The vasodilatory effect of Verapamil is also exploited to normalize elevated blood pressure (hypertension).

Pharmacokinetics and metabolism of Verapamil

After uptake via the mouth (orally) the drug is almost completely absorbed from the intestine into the blood. It follows a more rapid degradation especially in the liver. Slowly then the degradation products which are still effective even partly, excreted through the kidneys.

When should you use Verapamil?

Among the areas of application (indications) of Verapamil include:

  • heart rhythm (arrhythmia)
  • (essential hypertension)

How Verapamil is used

Normally, Verapamil is taken in pill form. The usual daily dose is in all areas of application (indications) 240 and 360 milligrams between. Only in very rare cases, more drug is needed.

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children, adolescents and patients with hepatic impairment receive a reduced dose.

It is important that the appropriate dose is determined slowly rising. Namely, given too much too soon Verapamil, may be caused by the vasodilator effect to a sudden drop in blood pressure. Also, the discontinuation of the drug should be done slowly (gradually).

What are the side effects of Verapamil?

Often, that is, at one to ten percent of those treated, can cause side effects such as Verapamil, sudden flushing (reddening) and swollen ankles (ankle edema). In addition, it can cause a slow heart rate (bradycardia) may occur.

rarely causes Verapamil excitation forwarding disturbance at the heart (AV block), (constipation), skin reactions and thickening of gums.

What should I watch for while taking Verapamil?

Medicines containing Verapamil, may not be used when it’s in the last eight weeks had a heart attack or suffering from severe hypertension.


Verapamil subject after its absorption into the blood immediately and a strong environmental degradation in the liver. Assuming additional medicines or substances that influence this conversion process, the effect can be increased or decreased by Verapamil.

The following substances strengthen the Verapamil therapy and drug reactions:

  • grapefruit
  • medicines for fungal infections (such as clotrimazole, ketoconazole and itraconazole)
  • for HIV (such as ritonavir or indinavir)
  • certain antibiotics (such as Erythromycin or Clarithromycin)
  • remedy for depression (such as Imipramine)
  • other agents for hypertension (such as Bisoprolol, Metoprolol, Ramipril)
  • Means other cardiac arrhythmias (such as Amiodarone)

The following resources reduced by the accelerated degradation Verapamil effect:

  • Phenytoin (medicines for epilepsy)
  • rifampicin (medicines for tuberculosis)
  • St. John’s wort (remedy for mild depressive moods)

Verapamil in turn may increase the effect of the following:

  • Carbamazepine (medicines for epilepsy)
  • alcohol

Driving and using machines

Because of the possible side effects dizziness should pay special attention at the beginning of therapy to the individual tolerance. Experts recommend to decide together with the attending physician, if you actively participate during treatment on the market or is permitted to operate heavy machinery.

Pregnancy and lactation

So far there are very few data on the use of Verapamil in pregnancy and lactation. It is known that the active substance can pass through the placenta (placenta) and via breast milk to the child. Because a harmful effect on the child can not be ruled out, experts recommend during pregnancy and lactation if possible on a better proven remedy for high blood pressure (such as alpha-methyldopa) avoid.

How to obtain medication with Verapamil

The treatment of a chronic disease such as hypertension or cardiac arrhythmia must be regularly checked by a doctor. Therefore, drugs are available by prescription with Verapamil. You get a prescription from a doctor in pharmacy.

Since when Verapamil is known?

Verapamil is already since the 1960s as a drug against cardiac arrhythmia known (licensed as a drug in the Netherlands in 1963). Its combined effect against cardiac arrhythmia and hypertension is regarded Verapamil as one of the main active ingredients in the field of cardiovascular disease.

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