Verapamil: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
*Atrial fibrillation, paroxysmal SVT | *[[Atrial fibrillation]], paroxysmal [[SVT]] | ||
**IV: 5-10mg (0.075-0.15 mg/kg), may give an initial 10mg IV after 30 minutes if inadequate response | **IV: 5-10mg (0.075-0.15 mg/kg), may give an initial 10mg IV after 30 minutes if inadequate response | ||
**PO: 240-48 mg daily in 3-4 divided doses | **PO: 240-48 mg daily in 3-4 divided doses | ||
*Angina, hypertension: 80-120mg PO 3 times per day | *Angina, hypertension: 80-120mg PO 3 times per day | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Afib/flutter, SVT | *[[Afib]]/[[flutter]], [[SVT]] | ||
**IV 0.1-0.2 (<1yo) or 0.1-0.3 (>1yo) mg/kg. Repeat after 30 minutes if inadequate response | **IV 0.1-0.2 (<1yo) or 0.1-0.3 (>1yo) mg/kg. Repeat after 30 minutes if inadequate response | ||
**PO: 4-10 mg/kg/day in 3 divided doses | **PO: 4-10 mg/kg/day in 3 divided doses | ||
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==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Afib/flutter associated with accessory bypass tract, e.g. WPW, long-ganong-levine | *Afib/flutter associated with accessory bypass tract, e.g. [[WPW]], [[long-ganong-levine]] | ||
*Cardiogenic shock, hypotension, EF <30% | *[[Cardiogenic shock]], [[hypotension]], EF <30% | ||
*2nd or 3rd degree AV block, sick sinus syndrome | *2nd or 3rd degree [[AV block]], [[sick sinus syndrome]] | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*AV block | *[[AV block]] | ||
*MI | *[[MI]] | ||
*Pulmonary edema | *[[Pulmonary edema]] | ||
===Common=== | ===Common=== | ||
*Hypotension | *[[Hypotension]] | ||
*Edema | *Edema | ||
*URI or flu-like symptoms | *[[URI]] or [[flu-like symptoms]] | ||
*Dizziness, headache | *[[Dizziness]], [[headache]] | ||
*Constipation | *[[Constipation]] | ||
==Pharmacology== | ==Pharmacology== | ||
Revision as of 06:46, 9 September 2016
Administration
- Type: Calcium channel blocker
- Dosage Forms:
- Routes of Administration: IV, PO
- Common Trade Names:
Adult Dosing
- Atrial fibrillation, paroxysmal SVT
- IV: 5-10mg (0.075-0.15 mg/kg), may give an initial 10mg IV after 30 minutes if inadequate response
- PO: 240-48 mg daily in 3-4 divided doses
- Angina, hypertension: 80-120mg PO 3 times per day
Pediatric Dosing
- Afib/flutter, SVT
- IV 0.1-0.2 (<1yo) or 0.1-0.3 (>1yo) mg/kg. Repeat after 30 minutes if inadequate response
- PO: 4-10 mg/kg/day in 3 divided doses
Special Populations
- Pregnancy Rating:
- Lactation risk:
- Renal dosing: no adjustment
- Hepatic dosing: 20-50% of normal dose
Contraindications
- Allergy to class/drug
- Afib/flutter associated with accessory bypass tract, e.g. WPW, long-ganong-levine
- Cardiogenic shock, hypotension, EF <30%
- 2nd or 3rd degree AV block, sick sinus syndrome
Adverse Reactions
Serious
Common
- Hypotension
- Edema
- URI or flu-like symptoms
- Dizziness, headache
- Constipation
Pharmacology
- Half-life: 4-20 hours
- Metabolism: Hepatic- P450 CYP3A4, CYP1A2, CYP2C8, CYP2C9 and CYP2C18
- Excretion: Renal primarily. Not dialyzable
Mechanism of Action
- Inhibits L-type (slow) calcium channels, blocking influx of calcium into myocardial cells
- Reduces systemic vascular resistance, vasodiolates peripheral arteries