Verapamil hydrochloride injection indications and usage: Difference between revisions

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Verapamil Hydrochloride Injection, USP is indicated for the following:
Verapamil Hydrochloride Injection, USP is indicated for the following:


* 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.
*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.
 
* 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).
 
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 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.
 
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.
[[Cardioversion ]]has been used safely and effectively after verapamil hydrochloride injection.
 


* 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).


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.
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.
Cardioversion has been used safely and effectively after verapamil hydrochloride injection.
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Revision as of 22:47, 4 March 2014

Verapamil
CALAN tablet® FDA Package Insert
Indications and Usage
Dosage and Administration
Dosage Forms and Strengths
Contraindications
Warnings and Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Overdosage
Description
Clinical Pharmacology
Nonclinical Toxicology
Clinical Studies
How Supplied/Storage and Handling
Patient Counseling Information
Labels and Packages
CALAN SR tablet extended release® FDA Package Insert
Indications and Usage
Dosage and Administration
Dosage Forms and Strengths
Contraindications
Warnings
Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Overdosage
Description
Clinical Pharmacology
Nonclinical Toxicology
How Supplied/Storage and Handling
Labels and Packages
VERAPAMIL HYDROCHLORIDE injection® FDA Package Insert
Indications and Usage
Dosage and Administration
Dosage Forms and Strengths
Contraindications
Warnings
Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Overdosage
Description
Clinical Pharmacology
Nonclinical Toxicology
How Supplied/Storage and Handling
Patient Counseling Information
Labels and Packages
Clinical Trials on Verapamil
ClinicalTrials.gov

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]

INDICATIONS AND USAGE

Verapamil Hydrochloride Injection, USP is indicated for the following:

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 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.

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 − seeCONTRAINDICATIONS and 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 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. Cardioversion has been used safely and effectively after verapamil hydrochloride injection.


[1]



References

  1. "VERAPAMIL HYDROCHLORIDE INJECTION, SOLUTION [CARDINAL HEALTH]".