Cardioselective calcium channel blockers. Phenylalkylamine derivatives
Verapamil blocks transmembrane calcium entry into cardiomyocytes and vascular smooth muscle cells. It directly reduces myocardial oxygen requirement by affecting energy consumption by the myocardial cells and due to decreased afterload.
– Ischemic heart disease, including stable angina; unstable angina (progressive angina, resting angina), vasospastic angina (Prinzmetal's variant angina), postinfarction angina in patients without heart failure, if b-blockers are not indicated.
– Arrhythmias: paroxysmal supraventricular tachycardia, atrial flutter/fibrillation with fast atrioventricular conduction (not including Wolff–Parkinson–White syndrome (WPW).
Doses are selected individually for each patient. The drug should be taken without sucking or chewing, with an adequate amount of liquid (e.g., 1 glass of water; avoid grapefruit juice), best during or just after a meal.
Adults and adolescents with at least 50 kg body weight.
Ischemic heart disease, paroxysmal supraventricular tachycardia, atrial flutter/fibrillation: the recommended daily dose is 120–480 mg divided into 3 to 4 doses. The maximum daily dose is 480 mg.
The recommended daily dose is 120 – 360 mg divided into 3 doses.
Children aged under 6 years, in arrhythmia only: the recommended daily dose is 80–120 mg divided into 2 to 3 doses.
Children aged 6 to 14 years, in arrhythmia only: the recommended daily dose is 80–360 mg divided into 2 to 4 single doses.