Verelan (Verapamil) Oral: Uses, Side Effects, Dosages - Verywell Health

What Is Verelan?

Verelan (verapamil) is an oral prescription medication used to treat high blood pressure (hypertension), chest pain (angina), and certain heart rhythm problems (arrhythmias).

Verelan belongs to a group of medications called non-DHP (nondihydropyridine) calcium channel blockers, which relax and widen blood vessels. This process decreases how hard the heart needs to work to pump blood throughout the body. Verelan also increases the amount of oxygen and blood delivered to the heart and helps control heart rate in people with certain heart rhythm problems.

Verelan is available in tablet and extended-release tablet and capsule forms.

Drug Facts

Generic Name: Verapamil 

Brand Name(s): Calan SR, Verelan, Verelan PM

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antianginal, antiarrhythmic class IV (4), antihypertensive

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Verapamil hydrochloride 

Dosage Form(s): Tablet, extended-release tablet, extended-release capsule

What Is Verelan Used For?

The Food and Drug Administration (FDA) approved Verelan to treat high blood pressure and control chest pain. Along with diet and exercise, medications that lower blood pressure can help decrease your risk of certain health conditions, including heart attack and stroke.

Different medications are often preferred over Verelan to treat high blood pressure. Still, your healthcare provider may prescribe Verelan if you also have other medical conditions such as atrial fibrillation (a-fib), atrial flutter, and rapid heart rate (supraventricular tachycardia).

How to Take Verelan

Verapamil comes as a tablet, an extended-release (long-acting) tablet, and an extended-release (long-acting) capsule to take by mouth. The regular tablet is usually taken three to four times a day. The extended-release tablets and capsules are typically taken once or twice a day. Take verapamil at around the same time(s) every day.

Be sure to swallow the Verelan capsule whole without crushing or chewing it. Because Verelan may increase the effects of alcohol, talk with your healthcare provider before you decide to drink.

Storage

Verelan should be stored at room temperature and kept away from excessive heat, moisture, or light. Do not store Verelan in the bathroom, as the heat and moisture can be detrimental to the integrity of the medicine. Instead, keep Verelan, and all your medications, in a safe location (a lockbox is often recommended) up high and out of the reach of children and teenagers.

Off-Label Uses

Healthcare providers may prescribe medications for uses other than those approved by the FDA. This is called off-label use. 

Verelan is sometimes used off-label for:

  • Idiopathic left ventricular tachycardia
  • Hypertrophic cardiomyopathy

How Long Does Verelan Take to Work?

After starting Verelan, you should begin to notice improvements in your blood pressure within one week.

What Are the Side Effects of Verelan?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some people may experience side effects while taking Verelan. Be sure to let your healthcare provider know if you have any side effects that bother you or don't go away. 

The most common side effects include:

Severe Side Effects

Rarely, Verelan may cause serious side effects. Call your healthcare provider right away if you develop any severe side effects. Call 911 if your symptoms feel life-threatening or if you think you are having a medical emergency. 

Serious side effects and their symptoms include:

  • Liver problems: Let your healthcare provider know if you experience any symptoms including dark urine, drowsiness, fever, light-colored stools, loss of appetite, pain in the upper right part of your belly, upset stomach, vomiting, yellowing of the skin or white parts of your eyes
  • Slow heartbeat (bradycardia), or abnormal heartbeat. 
  • Low blood pressure (hypotension): Symptoms include feeling very dizzy or passing out. 
  • Fluid retention (edema): Be sure to inform your healthcare provider if you notice a significant increase in weight, develop difficulty breathing, or have swelling in your arms or legs.

Report Side Effects

Verelan may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Verelan Should I Take?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For chest pain:
    • For oral dosage form (tablets):
      • Adults—The usual dose is 80 to 120 milligrams (mg) three times a day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .
    • For oral dosage form (extended-release tablets, 24 hr):
      • Adults—At first, 180 milligrams (mg) once daily at bedtime. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .
  • For heart rhythm problems:
    • For oral dosage form (tablets):
      • Adults—The total usual dose is 240 to 480 milligrams (mg) divided in three or four equal doses per day.
      • Children—Use and dose must be determined by your doctor .
  • For high blood pressure:
    • For oral dosage form (tablets):
      • Adults—At first, 80 milligrams (mg) three times a day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .
    • For oral dosage form (extended-release capsules):
      • Adults—At first, 200 milligrams (mg) once daily at bedtime. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .
    • For oral dosage form (extended-release tablets):
      • Adults—At first, 180 milligrams (mg) once daily in the morning. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .
    • For oral dosage form (extended-release tablets, 24 hr):
      • Adults—At first, 180 milligrams (mg) once daily at bedtime. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .

Modifications

If you have trouble swallowing pills, you can carefully open the Verelan capsules and sprinkle the pellets inside the capsule onto a spoonful of applesauce. Swallow the applesauce immediately without chewing. Do not use hot applesauce. After swallowing the applesauce, drink a small glass of cool water to ensure all the pellets have been consumed.

Moreover, it is important to note that Verelan is not removed in dialysis, so major caution is to be used for those with kidney disease.

Missed Dose

If you forget to take your dose of Verelan, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double up or take extra doses to compensate for a missed dose.

Overdose: What Happens If I Take Too Much Verelan?

Taking too much Verelan may cause serious effects, including arrhythmias.

Symptoms of a Verelan overdose include:

  • Low blood pressure
  • Slowed heart rate
  • Abnormal heart rhythms
  • Confusion

What Happens If I Overdose on Verelan?

Overdose symptoms may include low blood pressure, slowed heart rate, abnormal heart rhythms, high blood sugar, and confusion. 

If you think you or someone else may have overdosed on Verelan (verapamil), call your healthcare provider or the Poison Control Center.

If someone collapses or isn't breathing after taking Verelan (verapamil), call 911. 

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects .

Low blood pressure (hypotension) may occur while taking this medicine. Check with your doctor right away if you have the following symptoms: blurred vision; confusion; severe dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly; sweating; or unusual tiredness or weakness .

While you are taking this medicine be careful to limit the amount of alcohol that you drink. Alcohol increases dizziness and drowsiness and also lowers blood pressure .

What Are Reasons I Shouldn't Take Verelan?

Certain conditions increase the risk of developing complications from Verelan. Be sure to let your healthcare provider know about all your medical conditions and any allergies you have. 

Do not take Verelan if you:

What Other Medications Interact With Verelan?

Many drugs may interact with Verelan. Let your healthcare provider and pharmacist know about all the medicines you take—even over-the-counter (OTC) and nonprescription products.

Certain medications can cause serious reactions if taken with verapamil and should not be used together. These include:

  • Corlanor (ivabradine)
  • Norpace (disopyramide)—do not take 48 hours before or 24 hours after taking Verelan. 
  • Tikosyn (dofetilide)

Some drugs may decrease your heart rate or blood pressure excessively and can cause heart rhythm problems if taken with verapamil. Let your healthcare provider know if you take:

Statins: Verapamil may increase levels of certain statins—medications used to lower cholesterol. Taking verapamil with these drugs can increase your risk of developing muscle problems, which can sometimes be serious. It is important to know that some statins may also increase the levels of Verelan.

Your healthcare provider may start you on a lower dose of your statin medication if you take:

Verapamil can increase your risk of developing side effects from other medications, including:

This is not a complete list of all the medicines that may interact with Verelan. Always keep an up-to-date list of all the drugs you take, and let your healthcare provider and pharmacist know anytime there are changes.

What Medications Are Similar?

Verelan is a calcium channel blocker. Some calcium channel blockers work differently than others. Cardizem (diltiazem) is another calcium channel blocker similar to Verelan and is used to treat similar conditions.

Frequently Asked Questions

  • Verelan is approved by the FDA to treat high blood pressure (hypertension). Healthcare providers also use Verelan to treat chest pain (angina) and certain heart rhythm problems (arrhythmias).

  • Verelan is a calcium channel blocker. It works by relaxing blood vessels, increasing blood flow and oxygen delivery to the heart, and controlling heart rate.

  • Do not take Corlanor (ivabradine), Tikosyn (dofetilide), or Norpace (disopyramide) with Verelan since serious reactions can occur. Many other medicines interact with Verelan, so let your healthcare provider know about all your medications.

  • The most common side effects of Verelan include constipation, dizziness, and headache.

How Can I Stay Healthy While Taking Verelan?

If you've been diagnosed with high blood pressure or certain heart conditions, your healthcare provider may prescribe Verelan as one part of your treatment plan. Be sure to review all the warnings associated with Verelan and discuss any concerns with your healthcare provider before starting treatment. 

Because constipation is the most common side effect, it's important to ensure you eat a fiber-rich diet, drink enough water, and exercise (as directed by your healthcare provider). If you're still struggling with constipation, talk with your healthcare provider about other options. They may recommend an OTC laxative or stool softener to help with your symptoms.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

By Christina Varvatsis, PharmD
Christina Varvatsis is a hospital pharmacist and freelance medical writer. She is passionate about helping individuals make informed healthcare choices by understanding the benefits and risks of their treatment options.

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