Drug Title

Verapamil (Arpamyl)

Common use

Arpamyl is a Ca2+-channel blocker which relaxes (widens) veins and arteries, which makes it easier for the heart to pump and this way Arpamyl reduces its workload. Calcium triggers contraction of smooth muscles and when its entrance to the myocytes, it results in relaxation of the arterial muscles, improved oxygen delivery to the myocardial tissue, and decreased total peripheral resistance, systemic blood pressure, and afterload. Arpamyl also decreases the conduction of electrical impulses through the heart that control the coordination of contraction, this slows the rate of contraction. Arpamyl is used to treat hypertension, to treat angina, control some types of irregular heartbeats.

Dosage and direction

Take orally with or without food. Daily dose is 180-480 mg which may be taken as a single dose or divided in two or three intakes. Take exactly as prescribed by your doctor, never exceed the dose recommended to you.

Drug interaction

Arpamyl inhibits elimination of alcohol, increases the efficacy of doxorubicin both in tissue culture systems and in patients. Cyclophosphamide, oncovin, procarbazine, prednisone (COPP) and the vindesine, adriamycin, cisplatin (VAC) cytotoxic drug regimens are able to decrease absorption of Arpamyl. Co-administration of Arpamyl with aspiring in rare cases increases risk of bleeding. Correction of digoxin dosage is important in patients treated with Arpamyl. Chronic verapamil treatment can increase serum digoxin levels by 50% to 75% during the first week of therapy leading to digitalis toxicity. Co-administration with oral antihypertensive agents results in additive effects. Inform your doctor about all medications you take, especially about Disopyramide, Flecainide, Quinidine, Phenobarbital, Cyclosporin, medications which contain lithium. This medication may change results of certain liver tests to mildly abnormal.

Missed dose

Take the dose you forgot as soon as you remember. If it is almost time for your next intake just skip the next dose and return to your regular schedule.

Overdose

If you experience slow heartbeat and fainting, they may be symptoms of overdose. Seek for immediate medical attention if you suppose that too much of Arpamyl was taken.

Storage

Store at room temperature 15-30 C (59-86 F) away from light, moisture, pets and children.

Precautions

Avoid drinking alcoholic beverages, grapefruit juice or eating grapefruit. Alcohol is able worsen side effects of Arpamyl (drowsiness and dizziness) while grapefruit interacts with components of the drug. Do not get up too fast from a sitting or lying position as you may feel dizzy.

Contraindications

Arpamyl is contraindicated in patients with hypersensitivity to components of the medication, severe left ventricular dysfunction, hypotension (systolic pressure less than 90 mm Hg) or cardiogenic shock, sick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker), atrioventricular block degree II-III (except in patients with a functioning artificial ventricular pacemaker), atrial flutter or atrial fibrillation and an accessory bypass tract (Wolff-Parkinson-White, Lown-Ganong-Levine syndromes).

Side effects

Arpamyl is usually well tolerated.

Most common side effects include dizziness, weakness or fainting, swelling of the lower extremities, rash, headache, and constipation. Jaundice, swelling, difficulty breathing, rashes are also possible. If you experience severe side effects listed above seek for immediate medical attention.