Canis ISSN: 2398-2942

Verapamil

Introduction

Name

  • Verapamil.

Class of drug

  • Calcium channel blocker.
  • Class IV antidysrhythmic agent.

Uses

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Indications

  • Primarily used to control supraventricular tachycardias, sustained and paroxysmal ventricular tachycardias particularly in cases of hypertrophic cardiomyopathy Heart: hypertrophic cardiomyopathy (HCM) , and the heart rate in dogs with atrial fibrillation Heart: atrial fibrillation as an adjunct to digoxin Skin: hereditary lupoid dermatosis.
  • Management of feline hypertrophic cardiomyopathy ; calcium channel blockers are preferred to propanolol by some authors because they improve myocardial relaxation, increase ventricular filling and dilate coronary vasculature.
  • Management of hypertension Hypertension ; effective but to a lesser degree than diltiazem Diltiazem.

Administration

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Precautions

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Interactions

with other drugs



Beta-adrenergic blockers, eg propranolol
  • Propranolol Propranolol may be additive negative inotropic and chronotropic effects.
Calcium salts or vitamin D
  • The activity of verapamil may be adversely affected.
Cardiac glycosides
  • Digoxin Digoxin and digitoxin Digitoxin plasma concentrations are increased by verapamil Verapamil.
  • Monitor serum levels if used with verapamil.
Non-depolarizing muscle relaxants
  • Effects enhanced by verapamil.
Cimetidine
  • Cimetidine Cimetidine inhibits the metabolism of verapamil increasing plasma concentrations.
Theophylline
  • Verapamil enhances the effect of theophylline Theophylline possibly leading to toxicity.
Protein bound agents (eg warfarin)
  • Verapamil may displace these Warfarin from plasma proteins.
Vincristine
  • Verapamil may increase intracellular vincristine Vincristine levels by inhibiting the drugs outflow from the cell.

Further Reading

Publications

Other sources of information

  • Based onSmall Animal Formulary.Tennant, Bryn (1999) 3rd edn. Cheltenham: BSAVA.

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