Pharmacological properties

Verapamil (5-[(3.4 — dimetoksifenetit) - methylamine]-2-(3.4 — dimetoksifenit) - 2-izopropilvaleronitrit a hydrochloride) concerns antagonists of calcium ions of group of a fenilalkilamin; along with anti-adrenergic activity in the mechanism of effect of medicament an essential role is played also by increase in level of potassium in a myocardium.

Drug causes expansion of coronary vessels and increases a coronary blood stream, reduces the need of a myocardium for oxygen. In ischemia of a myocardium promotes reduction of a disproportion between requirement and supply of heart with oxygen, reduces contractility of a myocardium, significantly without changing at the same time warm emission. Verapamil oppresses sinuatrial and the AV conductivity, has antiarrhytmic effect (treats antiarrhytmic medicaments IV of a class). It has some natriuretic and diuretic effect due to decrease in a canalicular reabsorption. Slows down aggregation of thrombocytes.

in a liver therefore at disturbance of its functions discharge of medicament is considerably extended.

Indication

Verapamil as antiarrhytmic means is generally appointed in atrial arrhythmias — supraventricular Bouveret's diseases, premature ventricular contraction (in ventricular arrhythmias, including premature ventricular contraction, medicament is ineffective). verapamil is applied also at moderated ag (at severe forms ag nifedipine works much more effectively). depending on the nature of pathological process, verapamil is appointed in/in or inside. in/in a way of introduction it is more preferable in hypertensive crises, stenocardia attacks, paroxysms of supraventricular tachycardia. inside appoint at a chronic ischemic heart disease for the purpose of prevention of attacks of the angina of exertion (which is especially combined with atrial premature ventricular contraction and tendency to tachycardia).

Use

Inside in 30 min. prior to food (doses select individually). at easy forms of stenocardia appoint for 0.04-0.08 3–4 times a day. if necessary the single dose is raised to 0.16 g the daily dose makes 0.24-0.48 maintenance therapy by medicament in lower, individually picked up doses carry out is long.

to Children appoint medicament in low doses: aged up to 4 years inside on 0.02 g 2–3 times a day, up to 14 years — on 0.04 g 2–3 times a day.

Tolerance to verapamil at its prolonged use does not develop.

Contraindication

Cardiogenic shock, the profound arterial hypotension, an acute period of a myocardial infarction with av-blockade, i a pregnancy trimester, the feeding period a breast.

Side effects

nausea, vomiting, dizziness, increased fatigue, peripheral hypostases, allergic reactions, is more often — an atonic constipation (especially at long reception). high doses can cause arterial hypotension, av-blockade.

Interaction

is Carefully applied along with b blockers — adrenoceptors because of possible joint strengthening of their negative impact on intracardial conductivity and contractility of a myocardium.

Storage conditions

B the place protected from light.