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| __NOTOC__
| | #REDIRECT [[Verapamil#Adverse Reactions]] |
| {{Verapamil}}
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| {{CMG}}; {{AE}} {{AK}}
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| ==ADVERSE REACTIONS==
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| Serious adverse reactions are uncommon when CALAN therapy is initiated with upward dose titration within the recommended single and total daily dose. See [[Verapamil hydrochloride tablet warnings and precautions|WARNINGS]] for discussion of [[heart failure]], [[hypotension]], elevated liver enzymes, [[AV block]], and rapid ventricular response. Reversible (upon discontinuation of verapamil) non-obstructive, [[paralytic ileus]] has been infrequently reported in association with the use of verapamil. The following reactions to orally administered verapamil occurred at rates greater than 1.0% or occurred at lower rates but appeared clearly drug-related in clinical trials in 4,954 patients:
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| [[image:vera2.png]]
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| In clinical trials related to the control of ventricular response in digitalized patients who had [[atrial fibrillation]] or [[flutter]], ventricular rates below 50 at rest occurred in 15% of patients and asymptomatic [[hypotension ]]occurred in 5% of patients.
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| The following reactions, reported in 1.0% or less of patients, occurred under conditions (open trials, marketing experience) where a causal relationship is uncertain; they are listed to alert the physician to a possible relationship:
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| '''Cardiovascular:''' [[angina pectoris]], [[atrioventricular dissociation]], [[chest pain]], [[claudication]], [[myocardial infarction]], [[palpitations]], [[purpura]]([[vasculitis]]), [[syncope]].
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| '''Digestive system:''' [[diarrhea]], dry mouth, gastrointestinal distress, [[gingival hyperplasia]].
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| '''Hemic and lymphatic''': [[ecchymosis ]]or [[bruising]].
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| '''Nervous system:''' [[cerebrovascular accident]], [[confusion]], equilibrium disorders, [[insomnia]], [[muscle cramps]], [[paresthesia]], [[psychotic ]]symptoms, [[shakiness]], [[somnolence]], [[extrapyramidal symptoms]].
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| '''Skin:''' [[arthralgia ]]and [[rash]], [[exanthema]], hair loss, [[hyperkeratosis]], [[macules]], [[sweating]], [[urticaria]], [[Stevens-Johnson syndrome]],[[ erythema multiforme]].
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| '''Special senses:''' [[blurred vision]], [[tinnitus]].
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| '''Urogenital:''' [[gynecomastia]], [[galactorrhea]]/[[hyperprolactinemia]], increased urination, spotty [[menstruation]], [[impotence]].
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| ===Treatment of acute cardiovascular adverse reactions===
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| The frequency of cardiovascular adverse reactions that require therapy is rare; hence, experience with their treatment is limited. Whenever severe hypotension or complete AV block occurs following oral administration of verapamil, the appropriate emergency measures should be applied immediately; eg, intravenously administered [[norepinephrine ]]bitartrate, [[atropine ]]sulfate, [[isoproterenol ]]HCl (all in the usual doses), or [[calcium gluconate]] (10% solution). In patients with [[hypertrophic cardiomyopathy]] (IHSS), alpha-adrenergic agents ([[phenylephrine ]]HCl, [[metaraminol ]]bitartrate, or [[methoxamine ]]HCl) should be used to maintain blood pressure, and [[isoproterenol ]]and [[norepinephrine ]]should be avoided. If further support is necessary, [[dopamine]] HCl or [[dobutamine ]]HCl may be administered. Actual treatment and dosage should depend on the severity of the clinical situation and the judgment and experience of the treating physician.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = CALAN (VERAPAMIL HYDROCHLORIDE) TABLET, FILM COATED [G.D. SEARLE LLC DIVISION OF PFIZER INC] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=55d5f933-42ff-4c80-a102-0ccb7f76b082#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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