Verapamil is a Medicine belongs to Calcium Channel Blockers group whose information about Brand can be referenced from   Book : Martindale    Page : 1563   Edition : 37,

  ►   Brandname : Calaptin,Veramil,Cordilox,Half Securon,Calan,Covera,Isoptin,Verelan

  ►  Strength : Tablet with 40  Mg, Tablet with 80  Mg, Tablet with 120  Mg, Capsule with 100  mg, Capsule with 120  mg, Capsule with 180  mg, Capsule with 240  mg, Injection with 5/2  mg/ml,

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 250   Edition : 12,
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : IV, Oral,
Reference :-   Book : Martindale    Page : 1561   Edition : 37,

Dosing of Medicine differ in Adult & Pediatrics ↓


Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Arrhythmia IV 5 10 mg Injection Over 2 to 3 minutes.
2 Supraventricular arrhythmias Oral 120 480 mg Tablet Daily in 3 or 4 divided doses.
3 Angina pectoris Oral 120 mg Tablet t.i.d.
4 hypertension Oral 240 mg Tablet Daily in 2 or 3 divided doses.
5 Myocardial infarction Oral 360 mg Tablet Daily in divided doses.

Ref :-  Book : Martindale    Page : 1561   Edition : 37,




Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Supraventricular arrhythmias 1 Year IV 100 200 micrograms/kg Injection
2 Supraventricular arrhythmias 1 Year 15 Year IV 100 300 micrograms/kg Injection
3 Supraventricular arrhythmias 2 Year Oral 20 mg Tablet b.d/t.i.d
4 Supraventricular arrhythmias 2 Year <2 Year Oral 40 120 mg Tablet b.d/t.i.d

Ref :- Book : Martindale    Page : 1561   Edition : 37,
►  Organ Affected Cardiac disease (first degree heart block   hypotension)  

►  Side Effect : bradycardia, AV block, worsening of heart failure, transient asystole, constipation, nausea, hypotension, Dizziness, flushing, headache, fatigue, dyspnoea, peripheral edema, Skin reactions, hepatotoxicity, gingival hyperplasia,
Ref :-   Book : Martindale    Page : 1559   Edition : 37,

►  Drug Interaction : Drug interaction of Verapamil is with , Verapamil , Carbamazapine , Cyclosporine , Digoxin , Midazolam , Simvastatin , Theophylline , Zonisamide , , Isradipine , Mycophenolate mofetil , Mivacurium Chloride , Oxcarbazepine , Everolimus, Testosterone , Chlorpromazine , Felbamate, Insulin , Tolvaptan ,
Ref :-   Book : Martindale    Page : 1560   Edition : 37,


  ►    Mechanism of Drug Drug Interaction :  Verapamil is extensively metabolised in the liver and interactions may occur with drugs that inhibit or enhance hepatic metabolism. Grapefruit juice may cause increased plasma concentrations of verapamil. Drugs affected include carbamazepine, ciclosporin, digoxin, midazolam, simvastatin, and theophylline; the plasma concentration of alcohol may also be increased. Oral verapamil and beta blockers have been used together in the treatment of angina and hypertension but both drugs have cardiodepressant activity and the combination, if used at all, must be used with extreme caution; bradycardia, heart block, and left ventricular failure have been reported. Calcium salts antagonise the pharmacological response to verapamil. Verapamil increased the bioavailability ofm everolimus. ,
Ref :-   Book : Martindale    Page : 1560,1993   Edition : 37,


►  Absolute Contraindication : hypotension   cardiogenic shock   marked bradycardia   uncompensated heart failure   second- or third-degree AV block   sick-sinus syndrome   patients with atrial flutter or fibrillation and an accessory pathway with anterograde conduction.  

►  Contraindication : , cardiogenic shock, marked bradycardia, heart failure, Wolff-Parkinson-White syndrome, hepatic impairment, second -or- third degree AV block, sick-sinus syndrome,
Ref :-   Book : Martindale    Page : 1560   Edition : 37,
  ►  Mechanism of Action :   Verapamil is a phenylalkylamine calcium-channel blocker and a class IV antiarrhythmic. It slows conduction through the AV node, and thus slows the increased ventricular response rate that occurs in atrial fibrillation and flutter. Its anti-anginal effect is mainly due to coronary and peripheral vasodilatation, although it also inhibits coronary artery spasm; the decrease in peripheral vascular resistance reduces the work of the heart, which has a sparing effect on myocardial intracellular oxygen consumption. The decrease in peripheral vascular resistance may also explain its antihypertensive effect.,
Ref :-   Book : Martindale    Page : 1561   Edition : 37,

Pathway of Dietry Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- Stephania tetrandra with Another pathway, Ginger (Zingiber officinale) with same pathway, Quercetin with same pathway,

  ►  Pathway with its reference as follows :-
  • Tetrandrine have Cardio protective effect --- (PDR for Herbal medicines. (2000) (4th ed.). U.S. )
  • Ca2+ channel-blocking activity --- (Ghayur M. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. Journal of Cardiovascular Pharmacology. 2005;45(1):74-80. )
  • Ca2+ channel-blocking activity --- (Ghayur M. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. Journal of Cardiovascular Pharmacology. 2005;45(1):74-80. )

  •   ►  URL -- http://www.travolekar.ru/arch/Pdr_for_Herbal_Medicines.pdf, https://insights.ovid.com/pubmed?pmid=15613983,


    Dietry Substance Interactions


    ​   ► This Medicine interact with :- CALCIUM with Dietary Substance is Drug Inhibitor, CALCIUM with Decrease in Nutrient Level, VITAMIN D with Dietary Substance is Drug Inhibitor, MORIN with Dietary Substance is Drug Enhancer, NARINGENIN with Dietary Substance is Drug Enhancer, QUERCETIN with Dietary Substance is Drug Enhancer, ST JOHNS WORT with Dietary Substance is Drug Inhibitor,

      ►  Reference :-
  • Williamson, E. (2009). Stockley's Herbal Medicines Interaction .. London: Pharmacutical press.
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Williamson, E. (2009). Stockley's Herbal Medicines Interaction .. London: Pharmacutical press.
  • Williamson, E. (2009). Stockley's Herbal Medicines Interaction .. London: Pharmacutical press.
  • Williamson, E. (2009). Stockley's Herbal Medicines Interaction .. London: Pharmacutical press.
  • Driver, S. (2009). Stockleys Herbal Medicines Interactions. Royal pharmaceutical Society of Great Britain: Pharmaceutical press.

  •   ►  URL -- http://www.otto-wipfel.co.uk/otto/supplements-medication/DRUG-HERB-VITAMINS-INTERACTIONS-A-Z_Guide.pdf, https://www.stonybrookmedicine.edu/sites/default/files/herbal_medicines_interactions-1.pdf , https://www.stonybrookmedicine.edu/sites/default/files/herbal_medicines_interactions-1.pdf ,


    ContraIndication Dietry Substance


    ​   ► This Medicine contraindicate with :- PLEURISY ROOT with It contains cardiac glycosides , it is best to avoid use of pleurisy root with heart medications such as calcium ., HOWTHORM with Intensify the blood pressure lowering effect ., CALCIUM with Calcium supplementation has been reported to reverse the blood pressure - lowering actions of this drug when used to treat arrhythmias ., GRAPE FRUIT JUICE with It increase verapamil blood level ., VITAMIN D with It interfere with the effectiveness of drug verapamil .,

      ►  Reference :-
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press

  •   ►  URL -- http://www.otto-wipfel.co.uk/otto/supplements-medication/DRUG-HERB-VITAMINS-INTERACTIONS-A-Z_Guide.pdf, https://books.google.co.in/books?id=WZhj8EO9N3sC&pg=PA49&lpg=PA49&dq=The+New+Age+of+nutritional+and+herbal+remedies.++book&source=bl&ots=UVld-vNZL0&sig=5KwkKUUvW45p0TkfVUCtMZxnbow&hl=en&sa=X&ved=0ahUKEwiajLCNocrOAhVMto8KHfD2D-4Q6AEIMDAE#v=onepage&q=The%20,

    ►   Route of Elimination :   Fecal, Hepatic (Metabolism),
    Ref :-   Book : Martindale    Page : 1561   Edition : 37,


    ►    Plasma Half-life :   Min value :-   2 hours,    Max value :-   8 hours,
    Ref :-   Book : Martindale    Page : 1561   Edition : 37,


    ►    Peak Plasma Concentration :   Min value :-   1 hour,    Max value :-   2 hours,
    Ref :-   Book : Martindale    Page : 1561   Edition : 37,