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 (El 04), titanium dioxide (El 71), microcrystalline cellulose (E460), hydroxypropyl­cellulose (E463), methylhydroxy­propylcellulo­se (E464), purified talc (E553).

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 December 2020

accord

Package leaflet: Information for the patient

Verapamil 40mg, 80mg, 120mg and 160mg tablets

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, askyour
• 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.

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.

What is in this leaflet

• □ What Verapamil tablets are and what they are used for

El

What you need to know before you take Verapamil tablets

El

How to take Verapamil tablets

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Possible side effects

0

How to store Verapamil tablets

Contents of the pack and other information

□ 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:

El

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 or severe problems with the impulses and rhythms of the heart (second or third degree atrioventricular block or sick sinus syndrome) unless you have a pacemaker
• have heart failure and are taking beta blockers
• 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:

• had a heart attack or have problems with the impulses of the heart (first degree atrioventricu­lar block)
• liver disease
• kidney failure.

Surgery

You should tell your doctoryou are taking Verapamil tablets if you are having an operation or anaesthetic.

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)
• 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 orflecainide (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
• if you are about to receive surgery where an anaesthetic will be used (including dentistry).

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, thinkyou may be pregnant or are planning to have a baby, askyour 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 (El 10)

Sunset yellow aluminium lake (El 10) may cause allergic reactions.

E] 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, oryou thinka 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.

□ 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 symptoms occur:

• allergic reaction: itching, rashes, difficulty breathing and swelling of the face, lips or tongue
• Steven-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.

How to store Verapamil tablets

[3

Contents of the pack and other information

□ 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:

El

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 or severe problems with the impulses and rhythms of the heart (second or third degree atrioventricular block or sick sinus syndrome) unless you have a pacemaker
• have heart failure and are taking beta blockers
• 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:

• had a heart attack or have problems with the impulses of the heart (first degree atrioventricu­lar block)
• liver disease
• kidney failure.

Surgery

You should tell your doctoryou are taking Verapamil tablets if you are having an operation or anaesthetic.

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)
• 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 orflecainide (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
• if you are about to receive surgery where an anaesthetic will be used (including dentistry).

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, thinkyou may be pregnant or are planning to have a baby, askyour 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 (El 10)

Sunset yellow aluminium lake (El 10) may cause allergic reactions.

E] 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, oryou thinka 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.

□ 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 symptoms occur:

• allergic reaction: itching, rashes, difficulty breathing and swelling of the face, lips or tongue
• Steven-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.