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| __NOTOC__
| | #REDIRECT [[Verapamil#Adult Indications and Dosage]] |
| {{Verapamil}}
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| {{CMG}}; {{AE}} {{AK}}
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| ==INDICATIONS AND USAGE==
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| Verapamil Hydrochloride Injection, USP is indicated for the following:
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| * Rapid conversion to sinus rhythm of [[PSVT|paroxysmal supraventricular tachycardias]], including those associated with accessory bypass tracts ([[Wolff-Parkinson-White ]][W-P-W] and [[Lown-Ganong- Levine]] [L-G-L] syndromes). When clinically advisable, appropriate [[vagal maneuvers ]](e.g., [[Valsalva maneuver]]) should be attempted prior to verapamil hydrochloride administration.
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| * Temporary control of rapid ventricular rate in [[atrial flutter]] or [[atrial fibrillation]] except when the [[atrial flutter]] and/or [[atrial fibrillation]] are associated with accessory bypass tracts ([[Wolff-Parkinson-White]] (W-P-W) and [[Lown-Ganong-Levine]] (L-G-L) syndromes).
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| In controlled studies in the United States, about 60% of patients with [[supraventricular tachycardia]] converted to normal sinus rhythm within 10 minutes after intravenous verapamil hydrochloride. Uncontrolled studies reported in the world literature describe a conversion rate of about 80%. About 70% of patients with [[atrial flutter]] and/or [[atrial fibrillation|fibrillation]] with a faster ventricular rate respond with a decrease in ventricular rate of at least 20%. Conversion of atrial flutter or fibrillation to sinus rhythm is uncommon (about 10%) after verapamil hydrochloride and may reflect the spontaneous conversion rate, since the conversion rate after placebo was similar. Slowing of the ventricular rate in patients with atrial fibrillation/flutter lasts 30 to 60 minutes after a single injection.
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| Because a small fraction (<1%) of patients treated with verapamil hydrochloride respond with life-threatening adverse responses (rapid ventricular rate in atrial flutter/fibrillation, and an accessory bypass tract, marked [[hypotension]], or extreme [[bradycardia]]/[[asystole ]]− see[[Verapamil hydrochloride injection contraindications|CONTRAINDICATIONS]] and [[Verapamil hydrochloride injection warnings|WARNINGS]]), the initial use of verapamil hydrochloride injection should, if possible, be in a treatment setting with monitoring and resuscitation facilities, including D.C.-cardioversion capability (see [[Verapamil hydrochloride injection adverse reactions|ADVERSE REACTIONS]], Suggested Treatment of Acute Cardiovascular Adverse Reactions). As familiarity with the patient’s response is gained, use in an office setting may be acceptable.
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| Cardioversion has been used safely and effectively after verapamil hydrochloride injection.
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| <ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = VERAPAMIL HYDROCHLORIDE INJECTION, SOLUTION [CARDINAL HEALTH] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=0c27c868-7eae-4b3e-babf-e89404ea27b7#nlm34090-1 | publisher = | date = | accessdate = }}</ref>
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| ==References==
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| {{Reflist|2}}
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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