Verapamil ER (Verelan) is used to treat high blood pressure (hypertension). It's an extended-release (ER) medication that works throughout the day and is available as a tablet and capsule.
High blood pressure
Verapamil ER (Verelan) is a calcium channel blocker (CCB). It works by blocking calcium from entering your heart muscle. This helps lower how much your heart works to squeeze (contract) and relax. It also relaxes and opens up your blood vessels, including those of your heart. By relaxing your heart muscle and blood vessels, verapamil ER (Verelan) helps lower your blood pressure.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Blue lips and fingernails
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
confusion
coughing that sometimes produces a pink frothy sputum
difficult, fast, noisy breathing, sometimes with wheezing
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
increased sweating
lightheadedness, dizziness, or fainting
pale skin
shortness of breath
slow or irregular heartbeat
sweating
swelling in legs and ankles
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Difficulty having a bowel movement (stool)
headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Lowers blood pressure, which lowers the risk of stroke and heart attack
Only need to take once daily
Capsule can be opened and contents (pellets) can be mixed in with applesauce for people who have trouble swallowing pills
Available in a lower-cost generic form
Doesn't treat irregular heart rate or chest pain like the immediate-release form
Has many undesirable side effects, such as headache, dizziness, and swelling of the arms or legs
Must use with caution in people with liver or kidney disease
If you're switching from the immediate-release form to verapamil ER (Verelan), your total daily dose should stay the same unless your healthcare provider changes your dose. Instead of taking multiple doses throughout the day, you'll only have to take verapamil ER (Verelan) once daily because it's an extended-release medication. This means that the medication is slowly released throughout the day to maintain steady levels in your body.
If you're taking the capsules (Verelan, Verelan PM) but are having trouble swallowing, you can open the capsule and sprinkle the pellets inside onto 1 tablespoon of applesauce. Swallow the applesauce mixture right away, making sure not to chew or crush the pellets. Then, drink a cold glass of water to make sure you completely swallow the pellets for a full dose. Don't save the mixture or split up the contents of your capsule for later use, because it might not work as well and you won't get the full effects of the medication.
Verapamil ER (Verelan) doesn't allow your body to remove alcohol like it should. This can lead to high levels of alcohol in your blood and longer lasting effects of alcohol on your body. For your safety, limit alcohol use and let your healthcare provider know if you have a history of alcohol use.
Let your pharmacist or healthcare provider know if you take a statin medication for high cholesterol. Taking verapamil ER (Verelan) with statins, like atorvastatin (Lipitor) and simvastatin (Zocor), can lead to muscle breakdown and muscle weakness. The dose of your statin medication might need to be lowered before you start using verapamil ER (Verelan).
Store verapamil ER (Verelan) at room temperature in a place away from heat, light, and moisture. Close your medication bottle tightly and keep it out of reach from children at all times.
Verapamil ER (Verelan) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of heart disease
Verapamil ER (Verelan) can cause heart failure and fluid buildup in your lungs. Heart failure means your heart isn't pumping blood as well as it should. If you have a history of heart disease or heart-related problems, let your healthcare provider know before you start verapamil ER (Verelan). You might need to take other medications, such as water pills (diuretics), to help manage your heart problem. Symptoms of heart failure include shortness of breath, tiredness, swelling of the feet, legs, or stomach, quick weight gain, dizziness, and cough.
Risk factors: History of low blood pressure | Taking blood pressure medications
Verapamil ER (Verelan) can sometimes cause your blood pressure to drop to seriously low levels. This isn't very common if you have high blood pressure, but it's still possible. Tell your healthcare provider if you have symptoms of low blood pressure, including dizziness, lightheadedness, or weakness or tiredness, and especially if you experience blurred vision, thirst (dehydration), sweating, cold or pale skin, fast breathing, or confusion.
Risk factors: History of liver disease
Verapamil ER (Verelan) can raise the level of liver proteins in your blood. These levels are checked when you get bloodwork done to monitor the health of your liver. Some of these elevations are harmless and disappear as you continue using verapamil ER (Verelan). Other times, it can lead to more serious liver problems. If you have a history of liver disease, let your healthcare provider know before starting verapamil ER (Verelan). You might need routine bloodwork to make sure your labs are within the normal range. Let your provider know right away if you notice yellowing of your skin or eyes (jaundice), stomach pain or swelling, loss of appetite, dark urine, nausea, vomiting, tiredness, weakness, or confusion. These can be signs of liver injury.
Risk factors: Taking other blood pressure medications, especially beta-blockers
Verapamil ER (Verelan) can cause changes in your heart rhythm, including temporarily lowering your heart rate. Rarely, it can also cause a heart rhythm problem called heart block (AV block), which can be life-threatening. If this occurs, your dose might have to be lowered or you might have to completely stop taking verapamil ER (Verelan). Call for emergency medical help if you have chest pain, dizziness, shortness of breath, severe tiredness, feel like fainting, or feel like your heart skipped a beat.
Risk factors: Wolff-Parkinson-White or Lown-Ganong-Levine syndrome | Hypertrophic cardiomyopathy | Taking verapamil by injection
Before starting verapamil ER (Verelan), make sure your healthcare provider knows your full medical history, especially if you have any heart-related problems.
If you have an irregular heart rate (e.g., atrial fibrillation or A-fib, atrial flutter) and you're born with extra heart muscle tissue, don't take verapamil ER (Verelan), as this medication might put you at a higher risk for ventricular fibrillation (V-fib). This is a serious heart rhythm condition that can be life-threatening if not treated right away. V-fib was seen in people taking the injection form of verapamil, but you should still take similar precautions with oral forms of verapamil as well. Symptoms of V-fib include chest pain or pressure, shortness of breath, nausea, and vomiting.
If you have a genetic heart condition called hypertrophic cardiomyopathy (HCM), take verapamil ER (Verelan) with caution. HCM causes your heart muscle to grow thicker, making it harder for your heart to pump blood to the rest of your body. If you have HCM, verapamil ER (Verelan) can cause serious complications, such as fluid buildup in your lungs, severely low blood pressure, slow heart rate, heart block, and even death. Let your healthcare provider know if you have HCM because you might need to use a lower dose of verapamil ER (Verelan).
Your healthcare provider will adjust your dose based on how well you tolerate the medication and how well the medication is working for you.
Note: Sustained-release (SR) is another term for the extended-release form.
Tablet (brand-name Calan SR):
The typical starting dose is 180 mg by mouth once daily in the morning.
Capsule
Brand-name Verelan: The typical dose is 240 mg by mouth once daily in the morning.
Brand-name Verelan PM: The typical dose is 200 mg by mouth once daily at bedtime.
Your dose might differ if you're of older age, have low body weight, or have liver or kidney problems.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Complication on the left side of your heart (left ventricular dysfunction)
Low blood pressure (systolic pressure less than 90 mmHg) or heart unable to pump enough blood (cardiogenic shock)
Heart rhythm problem (sick sinus syndrome)
2nd- or 3rd-degree heart block
Irregular heart rate (e.g., atrial fibrillation or atrial flutter) and being born with extra heart muscle tissue (Wolff-Parkinson-White or Lown-Ganong-Levine syndrome)
Chest pain (angina)
Prevention and treatment of certain types of arrhythmias
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