Verapamil Extended-release

  • Hypertension

Verapamil Extended-release Generic Name & Formulations

General Description

Verapamil HCl 120mg, 180mg+, 240mg+; ext-rel tabs; +scored.

Pharmacological Class

Calcium channel blocker (CCB) (diphenylalkylamine).

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How Supplied

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Mechanism of Action

Verapamil is a calcium ion influx inhibitor (slow-channel blocker or calcium ion antagonist) that exerts its pharmacologic effects by modulating the influx of ionic calcium across the cell membrane of the arterial smooth muscle as well as in conductile and contractile myocardial cells.

Verapamil Extended-release Indications



Verapamil Extended-release Dosage and Administration


Take with food. Initially 180mg in the AM; may titrate to max 480mg/day in divided doses. Elderly or small patients: initially 120mg in the AM.


<18yrs: not established.

Verapamil Extended-release Contraindications


Severe left ventricular (LV) dysfunction or LV dysfunction treated with β-blockers. Moderate to severe heart failure. Hypotension. Cardiogenic shock. Sick sinus syndrome, 2nd- or 3rd-degree AV block, unless paced. Atrial flutter or fibrillation and an accessory bypass tract.

Verapamil Extended-release Boxed Warnings

Not Applicable

Verapamil Extended-release Warnings/Precautions


Control mild ventricular dysfunction (eg, with digitalis, diuretics) before initiation. AV conduction or neuromuscular transmission disorders. Hepatic or renal impairment. Monitor liver function periodically. Hypertrophic cardiomyopathy. Pregnancy. Nursing mothers: not recommended.

Verapamil Extended-release Pharmacokinetics

See Literature

Verapamil Extended-release Interactions


Potentiates alcohol, β-blockers, other antihypertensives, digitalis, theophylline, neuromuscular blockers, flecainide, carbamazepine, cyclosporine, lovastatin (limit to max 40mg/day), simvastatin (limit to max 10mg/day), atorvastatin (use lower doses). Avoid ivabradine; quinidine in hypertrophic cardiomyopathy; disopyramide within 48hrs before or 24hrs after verapamil. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir), grapefruit juice; antagonized by CYP3A4 inducers (eg, phenobarbital, rifampin). Inhalation anesthetics may potentiate cardiac depression. May increase bleeding with aspirin. Monitor theophylline, lithium. Concomitant mTOR inhibitors (eg, sirolimus, temsirolimus, everolimus); consider dose reductions of both drugs. Monitor heart rate with concomitant clonidine.

Verapamil Extended-release Adverse Reactions

Adverse Reactions

Constipation, dizziness, nausea, hypotension, headache, edema, CHF, fatigue, dyspnea, bradycardia, AV block, rash, flushing, elevated liver enzymes; rare: paralytic ileus.

Verapamil Extended-release Clinical Trials

See Literature

Verapamil Extended-release Note

Not Applicable

Verapamil Extended-release Patient Counseling

See Literature