Patient leaflet - VERAPAMIL 40 MG TABLETS
VERAPAMIL 40 mg, 80 mg & 120 mg TABLETS
Verapamil hydrochloride
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
– If you have any further questions, ask your doctor or pharmacist.
– This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
– If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
THIS LEAFLET CONTAINS
1. What Verapamil is and what it is used for
2. What you need to know before you take Verapamil
3. How to take Verapamil
4. Possible side effects
5. How to store Verapamil
6. Contents of the pack and other information
1. WHAT VERAPAMIL IS AND WHAT IT IS USED FOR
Verapamil belongs to a group of medicines called calcium channel blockers. The heart muscle and the muscle in your blood vessel walls need calcium to contract and tighten.
Verapamil stops calcium from getting into these muscles. This
- relaxes your heart and blood vessels
- makes your heart pump out less blood every time it beats
- slows down your heart rate (pulse).
Verapamil can be used to:
- treat high blood pressure (hypertension). It may be prescribed on its own or in combination with other heart medicines
- treat and prevent chest pain (angina)
- treat and prevent heart rhythm problems such as heart flutter (supraventricular tachycardia).
If you are not sure why you have been prescribed this medicine then please ask your doctor.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE VERAPAMIL
If the answer to any of the following questions is ‘YES’ please tell your doctor or pharmacist before taking any tablets:
- Are you sensitive (allergic) to Verapamil or any other ingredients in the tablets (see section 6)
- have second or third-degree atrioventricular block or sino-atrial block. This is a disorder where parts of your heart may beat at the wrong time causing it not to pump blood around the body very well
- sick sinus syndrome
- do you have or have you ever suffered from heart problems such as heart failure or the heart condition called Wolff-Parkinson-White syndrome?
- do you have an abnormally slow or irregular heart beat?
- do you have very low blood pressure?
- have you recently had a heart attack?
- do you have liver or kidney problems?
- do you have a condition where the nerve to muscle transmission is affected e.g. myasthemia gravis, Lambert-Eaton syndrome, advanced Duchenne muscular dystrophy?
- are pregnant or planning to become pregnant, or are you breast-feeding?
- are you being treated with ivabradine (for heart conditions)?
- Your doctor may monitor your blood pressure regularly.
Other medicines and Verapamil tablets
Please tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines bought without a prescription.
In particular, any of the following:
- Medicines to treat heart failure, such as Digoxin, Digitoxin or Eplerenone
- as beta blockers used to treat high blood pressure and heart conditions (these include Atenolol, Metoprolol or Propranolol)
- Alpha blockers used to treat high blood pressure and heart conditions (these include Prazosin and Terazosin)
- Diuretics (also called ‘water pills’)
- Medicines known as ‘statins’ such as Simvastatin, atorvastatin or lovastatin used to lower cholesterol levels
- Any other medicines used for high blood pressure or an abnormal heart beat (arrhythmia) such as Disopyramide, Flecainide or Quinidine, digoxin and digitoxin
- Dabigatran (medicine to prevent the formation of blood clots)
- Medicines containing ivabradine for the treatment of certain heart diseases
- Medicines to treat depression (including the herbal product St John’s Wort), anxiety or psychosis. These may include imipramine, buspirone and lithium
- Medicines known as immunosuppressants such as Ciclosporin, Everolimus, Sirolimus or Tacrolimus. These are used to prevent organ transplant rejection
- Glibenclamide, used to treat certain types of diabetes
- Aspirin, a non-steroidal anti-inflammatory painkiller (NSAID) used to relieve pain and reduce fever
- Almotriptan, used to treat migraine
- Midazolam used as a sedative or anaesthetic
- Theophylline to treat asthma
- Doxorubicin, an anti-cancer medicine
- Cimetidine used to treat indigestion or stomach ulcers
- Rifampicin used to treat tuberculosis and other types of infection
- Carbamazepine, Phenytoin or Phenobarbital (phenobarbitone). These medicines are used as anti-convulsants
- Ritonavir used to treat HIV
- Clarithromycin, Erythromycin or Telithromycin, used to treat types of infection infections
- Colchicine or suplfinpyrazone used to treat gout
- Verapamil may decrease the glucose-lowering effect of metformin.
Tell your surgeon or dentist you are taking Verapamil if surgery is planned as it, may affect the anaesthetic used.
Driving and using machines
Do NOT drive, operate machinery or do anything that requires you to be alert, until you know how the tablets affect you.
Verapamil can make some people feel dizzy, especially when they first start to take the tablets.
Verapamil tablets with food, drink and alcohol
Do NOT drink grapefruit juice whilst taking your tablets as it can affect the absorption of this medicine. This does not occur with other fruit juices such as orange, apple or tomato juice.
Verapamil will increase the time your body gets rid of alcohol. This means that you may not have to drink as much for your blood alcohol levels to be above the legal limit to drive. It will also take you longer to sober up.
Pregnancy and breast-feeding
Please discuss with your doctor if you are pregnant, planning to become pregnant or are breast-feeding.
- You must only take this medicine in the first 3 months of pregnancy (1st trimester) if your doctor thinks it is essential
- You must only take this medicine if you are breast-feeding if your doctor thinks it is necessary
Verapamil tablets contains lactose and sunset yellow (E110)
- lactose (a type of sugar). If your doctor has told you that you cannot tolerate some sugars, see your doctor before taking this medicine.
- sunset yellow (E110), which may cause allergic reactions.
3. HOW TO TAKE VERAPAMIL
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor if you are not sure. Swallow this medicine with a glass of water. Take your tablets with a glass of water. You should swallow the tablets without chewing or crushing them. It does not matter if you have not eaten.
Adults
The recommended dose is:
For high blood pressure: 120 mg tablet twice a day. Your doctor may increase this to a maximum of 160 mg two or three times a day.
For angina:
120 mg three times a day. Your doctor may lower this dose.
For heart rhythm disorders:
40 mg to 120 mg three times a day.
Elderly
The dose will be the same as that for adults. If you have a liver or kidney problem, your doctor may lower your dose.
Children
The doctor will decide if this medicine is suitable for your child, depending on your child’s condition and age.
The recommended dose for children is:
Up to 2 years of age: 20 mg two or three times a day. 2 years of age and above: 40 mg to 120 mg two or three times a day.
If you take more Verapamil tablets than you should Talk to a doctor or go to a hospital straight away. Take the medicine pack with you so the doctor knows what you have taken.
The main symptoms are as follows: blood pressure fall, shock symptoms, loss of consciousness, 1st and 2nd degree AV block (frequently as Wenckebach's phenomenon with or without escape rhythms and includes impairment of conduction in the heart which slows, blocks and causes potentially life-threatening rhythm disturbances), total AV block with total AV dissociation (absence of conduction in the heart which can lead to sudden cardiac death), escape rhythm (occurs when there is failure to produce an impulse in the heart), asystole (a condition in which the heart ceases to beat), bradycardia (a slow heart rate) up to high degree AV block and sinus arrest (the heart transiently ceases to generate the electrical impulses), hyperglycaemia (increased glucose in the blood), stupor (a state of near-unconsciousness or insensibility) and metabolic acidosis (imbalance in the body's acid-base balance).
If you forget to take Verapamil tablets
Take your tablets as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose. Do not take a double dose (two doses at the same time) to make up for a forgotten dose.
If you stop taking Verapamil tablets
Do not stop taking this medicine without talking to your doctor first. If you stop taking this medicine it may make your condition worse.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. possible side effects
As with all medicines, Verapamil tablets can cause side effects, although not everybody will suffer from them. If you experience any other unusual symptoms whilst taking your tablets, tell your doctor or pharmacist.
Tell your IMMEDIATELY if you experience any of the following side effects:
- yellowing of the skin or eyes, a fever or tenderness around the middle. These are signs that your liver may not be functioning as well as usual.
- Palpitations (rapid, strong, or irregular heartbeat), chest pains for the first time or chest pains becoming more frequent, swollen ankles, hot and painful hands or feet
- Unexpected wheezing, fluttering or tightness of your chest or collapse, swelling of your mouth lips or severe skin rash, difficulty breathing
- swelling of the limbs
- An allergic reaction which may cause an itchy skin rash, flaking skin, red and raised lumps (hives), blistering of your skin, mouth, eyes or genitals, sudden
- Heart problems such as low blood pressure (hypotension), slow heart beats, unusual heart beats, heart attack or heart failure. This is more likely if you are taking high doses or you already have damage to your heart
The most common side effect is constipation. Other side effects include abnormal heart beat, flushing of the neck or face, headaches, feeling or being sick , abdominal pain or discomfort, dizziness, vertigo (feels like a spinning or swaying, loss of balance), tinnitus (ringing or buzzing in the ears), tiredness, tremor or movement disorders, muscle weakness, aches and pains in the joints and/or muscles, numbness, a tingling or prickling feeling on the skin, skin rash or itching, hair loss. Impotence may occur rarely.
Other side effects might occur if verapamil is used for a long time. Tell your doctor if you develop swollen and overgrown gums which start to spread over your teeth, or if your breasts swell (males) or start to produce milk (males and females). These effects are rare and are resolved upon stopping taking the tablets.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at or search for MHRA Yellow Card in Google Play or Apple App Store.
5. how to store verapamil
Keep this medicine out of the sight and reach of children.
Do not store above 25°C. Store in the original package to protect from light or store in the original container and keep the container tightly closed.
Do not use this medicine after the expiry date, which is stated on the package or container. The expiry date refers to the last day of that month.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6. contents of the pack and other information
What Verapamil tablets contain
The active substance (the ingredient that makes the tablets work) is verapamil hydrochloride.
The other ingredients in the tablets are maize starch, lactose, gelatin, magnesium stearate, colloidal anhydrous silica, talc, titanium dioxide (E171), quinoline yellow (E104), sunset yellow (E110), hydroxypropyl cellulose, hydroxypropyl methylcellulose, ethylcellulose and diethyl phthalate.
What Verapamil tablets look like and contents of the pack
Verapamil tablets are round, convex, pale yellow, film coated tablets with a marking engraved on one side.
- The 40 mg tablets are engraved with MP68 and have a diameter of approximately 6.5 mm.
- The 80 mg tablets are engraved with MP69 and have a diameter of approximately 8 mm.
- The 120 mg tablets are engraved with MP70 and have a diameter of approximately 9.5 mm.