Verapamil Dosages: Your GoodRx Guide

Verapamil is in a class of medications called calcium channel blockers (CCBs). It’s FDA approved to treat many heart-related conditions, including chest pain, irregular heartbeats, and high blood pressure.

In this guide, we’ll go over typical verapamil dosages. But your healthcare provider may prescribe a different dosage from what’s discussed here — one that’s personalized for you. Make sure to follow their instructions closely and discuss any questions you have with them.

What dosage forms of verapamil are available?

Verapamil comes in immediate-release (IR) and extended-release (ER) forms. They’re all available as lower-cost generic options. The ER forms also come in brand-name versions.

• IR forms: tablet and injection

• ER forms: tablet (Calan SR) and capsule (Verelan, Verelan PM)

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If you’re prescribed the IR tablets, you’ll take them more frequently than the ER products. This is because the IR tablets don’t last as long in the body. The different oral verapamil forms and their FDA-approved uses are below:

What’s the typical verapamil dosage for adults?

The typical verapamil dosage depends on many factors. But regardless of why you take verapamil, you’ll likely start at a lower dose. Your healthcare provider may slowly raise your dose over the following days to weeks depending on how your body responds.

Your daily dose will usually stay the same if you switch from an IR to ER product. But switching from one ER product to another may not be as straightforward. Check with your provider before switching products.

High blood pressure

When verapamil is used for high blood pressure (hypertension), it’s commonly used in combination with another medication. This may include angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).

The usual doses of verapamil IR and ER are discussed in the table below.

Chest pain

Verapamil IR is approved to treat chest pain (angina). The usual verapamil dosage for angina is 80 mg to 120 mg three times a day.

Atrial fibrillation or atrial flutter

Verapamil is also used for conditions that are caused by irregular heartbeats (arrhythmias). These include atrial fibrillation and atrial flutter.

The usual daily dose of verapamil IR is 240 mg to 320 mg (divided into 3 or 4 doses) for “rate control.” Rate control medications slow down the heart rate.

Verapamil ER isn’t FDA approved for arrhythmias, but the national guidelines from the American College of Cardiology (ACC) and American Heart Association (AHA) recommend verapamil ER for atrial fibrillation at a dose of 180 mg to 480 mg once daily.

Paroxysmal supraventricular tachycardia

Paroxysmal supraventricular tachycardia (PSVT) is another type of arrhythmia. The manufacturer-recommended daily dose of verapamil IR is 240 mg to 480 mg (divided into 3 or 4 doses).

The ACC/AHA guidelines recommend a lower starting dose of 120 mg per day and a maximum dose of 480 mg per day. Though verapamil ER isn’t FDA approved for PSVT, the guidelines state that verapamil IR or ER can be used for PSVT.

Are there any necessary dosage adjustments?

Your healthcare provider might make dosage adjustments when prescribing verapamil depending on individual factors. For example, in older adults or people with a lower body weight, verapamil levels can build up in the body. So your healthcare provider might start you on a lower dose initially. You may also need a lower dose of verapamil if you have any of the following conditions:

• Liver problems

• Kidney problems

• Neuromuscular problems, including myasthenia gravis and Duchenne muscular dystrophy

Verapamil also has many drug interactions. This can result in lower or higher levels of verapamil or the interacting medication. So you might need dosage adjustments depending on what medications you take. This includes other blood pressure medications. Before starting verapamil, give your healthcare provider a list of all the medications and supplements you take. This will help them check for interactions.

Are there any specific instructions for taking verapamil?

The IR and ER verapamil tablets can be cut in half and each piece swallowed whole.

The ER capsules should be swallowed whole. If you have trouble swallowing pills, you can also open the capsules and mix the contents with one tablespoon of applesauce. Just make sure you swallow the mixture without chewing and drink a glass of cold water afterwards.

The ER tablets should be taken with food. Other forms of verapamil can be taken with or without food.

What happens if you miss a dose of verapamil?

If you miss a dose of verapamil, take it as soon as you remember. But if it’s close to your next scheduled dose, skip the missed dose and take your next dose at your usual time. Don’t try to make up for a missed dose by taking two doses together.

Tell your healthcare provider if you've missed several doses of verapamil. They may want you to check your blood pressure. Or they may adjust your dosing schedule. If you have trouble remembering to take your medications, you may want to consider setting reminders on your smartphone or getting a medication reminder app to help you remember.

What should you do if you take too much verapamil?

Taking too much verapamil can lead to low blood pressure and make other side effects more likely. This includes constipation, dizziness, and headaches. More seriously, this can include a slow heart rate or very low blood pressure.

If you take too much verapamil, you may need close monitoring for at least 48 hours. So even if you’re not sure how much verapamil you took, talk with your healthcare provider right away if you think you took too much. If you’re experiencing symptoms, call 911 or Poison Control at 1-800-222-1222.

How to save on verapamil

There are many ways to save on verapamil IR and ER. Both are available as lower-cost generics.

GoodRx may be able to help you save over 60% off the average retail price of the generic versions of verapamil IR and ER. With a free GoodRx discount, certain pharmacies may carry verapamil products for as low as:

• Verapamil IR: $11.70

• Verapamil ER tablets: $9.00

• Verapamil ER capsules: $9.00

Why trust our experts?

Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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