Patient leaflet - Verapamil tablets BP 160 mg
1 What Verapamil tablets are and what they are used for
Verapamil belongs to a group of medicines called calcium-channel blockers which interfere with the electrical signals in the heart muscle and blood vessels. It is used to:
- manage high blood pressure (hypertension), used alone or with other drugs for high blood pressure.
- manage and prevent angina.
- treat and prevent certain types of abnormal heartbeats.
2 What you need to know before you take Verapamil tablets
Do not take Verapamil tablets if you:
- are allergic to verapamil hydrochloride or any of the other ingredients of this medicine (listed in section 6)
- have heart failure, cardiogenic shock or severe problems with the impulses and rhythms of the heart (second or third degree atrioventricular block, sino-atrial block or sick sinus syndrome) unless you have a pacemaker
- have recently suffered a heart attack
- suffer from a slow heart rate (bradycardia)
- have low blood pressure (hypotension)
- have Wolff-Parkinson-White syndrome (rapid heart rate sometimes associated with dizziness or faintness)
- are already taking a medicine containing ivabradine for the treatment of certain heart diseases.
Warnings and precautions
Talk to your doctor or pharmacist before taking Verapamil tablets if you have:
- heart failure, have problems with the impulses of the heart (first degree atrioventricular block) or suffer from a slow heart rate (bradycardia)
- liver disease
- kidney failure
- a condition where the nerve to muscle transmission is affected e.g. myasthenia gravis, Lambert-Eaton-syndrome, advanced Duchenne muscular dystrophy.
Surgery
You should tell your doctor you are taking Verapamil tablets if you are having an operation or anaesthetic (including dentistry).
What Verapamil tablets look like and contents of the pack
Verapamil 40mg tablets are yellow, circular, biconvex film-coated tablets, impressed ‘‘C’’ on one face and the identifying letters ‘‘VR’’ on the reverse. Tablet diameter: 6.18-6.82mm.
Verapamil 80mg tablets are yellow, circular, biconvex film-coated tablets, impressed “C” on one face and the identifying letters “VS” on the reverse. Tablet diameter: 7.6-8.4mm.
Verapamil 120mg tablets are yellow, circular, biconvex film-coated tablets, impressed “C” on one face and the identifying letters “VT” on the reverse. Tablet diameter: 8.55-9.45mm.
Verapamil 160mg tablets are yellow, circular, biconvex film-coated tablets, impressed “C” on one face and the identifying letters “VU” on the reverse. Tablet diameter: 9.98-11.02mm.
Pack sizes are 28, 56 and 84.
Marketing Authorisation Holder and Manufacturer
Accord, Barnstaple, EX32 8NS, UK.
This leaflet was last revised in October 2024
51029997 BBBC0958
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page 2 page 3 Other medicines and Verapamil tablets
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, especially:
- ivabradine (for heart disease)
- alpha or beta blockers (particularly important if having a beta blocker by injection) and other drugs to treat high blood pressure e.g. prazosin
- cimetidine (to treat stomach ulcers)
- phenobarbital, carbamazepine or phenytoin (to treat epilepsy)
- rifampicin, erythromycin, clarithromycin or telithromycin (to treat infections)
- ritonavir (to treat HIV)
- lithium (to treat depression)
- theophylline (to treat asthma)
- digoxin (to treat certain heart conditions)
- buspirone (used to treat anxiety)
- midazolam (used as sedative or anaesthetic)
- statins e.g. simvastatin, atorvastatin (to lower cholesterol levels)
- imipramine (to treat depression, anxiety and panic disorder)
- aspirin (for pain, fever or to prevent blood clots)
- almotriptan (to treat migraine)
- dabigatran (medicine to prevent the formation of blood clots)
- quinidine or flecainide (to treat arrhythmias)
- colchicine or sulfinpyrazone (for gout)
- glibenclamide (to treat certain types of diabetes)
- doxorubicin (used in chemotherapy to treat some cancers)
- immunosupressants such as ciclosporin, sirolimus, everolimus and tacrolimus (to prevent organ transplant rejection)
- St. John’s Wort (for mild anxiety)
- metformin (to treat diabetes) as verapamil may decrease the glucose-lowering effect of metformin
- diuretics (‘water pills’), antihypertensives (to treat hypertension) or vasodilators (to open blood vessels).
Verapamil tablets and alcohol
Verapamil may increase the amount of alcohol in the body and the time it takes for alcohol to leave the body. You should avoid excessive amounts of alcohol whilst taking Verapamil tablets.
Verapamil tablets and Grapefruit juice Do not eat or drink products containing grapefruit juice whilst taking verapamil, as grapefruit juice increases the effects of verapamil.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
Verapamil tablets may make you feel drowsy, particularly when you first start the treatment and when changing over from another medicine. Make sure you are not affected before you drive or operate machinery, especially if taken with alcohol.
Verapamil tablets contain sunset yellow aluminium lake (E110)
Sunset yellow aluminium lake (E110) may cause allergic reactions.
Information on sodium content
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
3 How to take Verapamil tablets
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
The recommended dose is:
Adults
- High blood pressure: Initially 120mg twice a day increasing to 160mg twice a day. In some cases up to a maximum of 480mg a day can be taken in divided doses.
- Angina: Usually 120mg three times a day. For some patients 80mg three times a day may be sufficient.
- Abnormal heartbeats: 40-120mg three times a day.
Elderly with heart or liver problems: you may be given a different dose.
Use in children and adolescents
- Up to 2 years: 20mg two or three times a day.
- 2 years and over: 40-120mg two or three times a day.
Swallow the tablets whole with water, without chewing or crushing them.
If you take more Verapamil tablets than you should
If you (or someone else) swallow a lot of tablets at the same time, or you think a child may have swallowed any, contact your nearest hospital casualty department or tell your doctor immediately. Overdose can lead to low blood pressure and in rare cases heart failure.
If you forget to take Verapamil tablets
Do not take a double dose to make up for a forgotten dose. If you forget to take a dose, take it as soon as you remember. If it is nearly time for the next dose, skip the missed dose and take the next dose at the right time.
If you stop taking Verapamil tablets
Talk to your doctor before you stop taking the tablets and follow their advice.
If you stop taking your tablets your condition may get worse. It is important that you keep taking these tablets until your doctor tells you to stop, do not stop because you feel better.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4 Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Contact your doctor at once if any of the following serious symptoms occur:
- allergic reaction: itching, rashes, difficulty breathing and swelling of the face, lips or tongue
- Stevens-Johnson syndrome: symptoms include fever and flu-like symptoms, rash, skin blisters, peeling skin
- palpitations, chest pains for the first time or chest pains becoming more frequent
- liver problems which can be indicated by yellowing of the skin or eyes and detected by blood tests done by your doctor.
Tell your doctor if you notice any of the following side effects, they get worse or you notice any other effects not listed:
Nervous system – headaches, dizziness, ‘pins and needles’, involuntary shaking or spasm.
Ears – spinning sensation, ‘ringing in the ears’. Heart /blood vessels – fast, slow or irregular heartbeat, low blood pressure, flushing/reddening of the skin, swelling of the ankles, hands or feet.
Stomach – constipation, feeling or being sick, pain or discomfort in the stomach, swelling of the gums. Skin – hair loss, skin rash or itching, discolouring, burning pain associated with increased skin temperature. Muscles – muscle weakness, tremor, aches and pains in the joints and/or muscles.
Reproductive system – erectile dysfunction, enlarged breasts in men (reversible when treatment is stopped), milky secretion from the breasts.
Other – tiredness, increased levels of prolactin in the blood.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/ yellowcard or search for MHRA Yellow Card in Google Play or Apple App Store.
By reporting side effects you can help provide more information on the safety of this medicine.
5 How to store Verapamil tablets
Keep this medicine out of the sight and reach of children. Store below 25°C in a dry place.
Do not take this medicine after the expiry date which is stated on the carton. 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 protect the environment.
6 Contents of the pack and other information
What Verapamil tablets contain
- The active substance is verapamil hydrochloride. Each tablet contains either 40mg, 80mg, 120mg or 160mg of verapamil hydrochloride.
- The other ingredients are croscarmellose sodium, magnesium stearate, maize starch, propylene glycol, sunset yellow aluminium lake (E110), quinoline yellow aluminium lake (E104), titanium dioxide (E171), microcrystalline cellulose (E460), hydroxypropylcellulose (E463), methylhydroxypropylcellulose (E464), purified talc (E553).