Verogalid EP 240
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Verogalide EP 240 is a calcium channel blocker that has antianginal, hypotensive and antiarrhythmic effects.
Release form and composition
Dosage form - tablets of prolonged action, coated with a shell: white with a yellow tinge, oblong elongated biconvex shape, on one side there is a dividing line, on both sides of which there are marking "73" and "00", on the other side there are two triangles, facing each other (10 pcs. in a blister, in a cardboard box 1 or 3 blisters; 30 pcs. or 100 pcs. in plastic cans, in a cardboard box 1 can).
1 tablet contains:
- active substance: verapamil hydrochloride - 240 mg;
- auxiliary components: povidone, sodium alginate, magnesium stearate, microcrystalline cellulose;
- shell composition: Opadry yellow YS-5-12577 [macrogol (polyethylene glycol 400), hypromellose 3cP, hypromellose 50cP, titanium dioxide, hydroxypropylcellulose (hyprolose), dye yellow varnish], Opadry transparent YS-1-7006 [macrogol (polyethylene glycol 400), hypromellose 6cP, macrogol (polyethylene glycol 8000)].
Indications for use
- arterial hypertension;
- prevention of supraventricular tachyarrhythmia;
- prevention of angina attacks, including angiospastic.
Contraindications
- age up to 18 years;
- severe bradycardia;
- cardiogenic shock;
- arterial hypotension;
- acute phase of myocardial infarction complicated by severe arterial hypotension, symptoms of bradycardia, left ventricular failure;
- Wolff-Parkinson-White (WPW) syndrome;
- Morgagni-Adams-Stokes syndrome;
- sick sinus syndrome (SSS);
- aortic stenosis;
- sinoatrial blockade;
- atrioventricular (AV) block II – III degree;
- digitalis intoxication;
- intravenous administration of beta-blockers within the previous two hours;
- the period of pregnancy and breastfeeding;
- hypersensitivity to the components of the drug.
With caution, Verogalide EP 240 should be prescribed to patients with AV block I degree, arterial hypotension [systolic blood pressure (BP) below 90 mm Hg], chronic heart failure, atrial flutter or atrial fibrillation in WPW syndrome, impaired liver function.
During pregnancy or breastfeeding, taking pills is possible only as a last resort, when the expected benefit from therapy for the mother outweighs the potential threat to the fetus and child.
Method of administration and dosage
The tablets are taken orally, swallowing whole (without violating the integrity of the shell), during meals, with a sufficient amount of water.
Recommended dosage:
- arterial hypertension: 240-360 mg, usually 240 mg once a day (in the morning). In the absence of a sufficient therapeutic effect, this dose is supplemented with 120 mg in the evening. The maximum daily dose is 360 mg, the use of a daily dose of 480 mg can be performed only in a hospital setting. In case of impaired renal or liver function and in elderly patients, the initial dose of the drug should be 120 mg;
- prevention of supraventricular tachyarrhythmias: 120 mg 1-2 times a day;
- prevention of angina attacks: 120 mg 1-2 times a day. The maximum daily dose is 240 mg.
If the drug is taken twice a day, the second dose can be taken only after 12 hours.
Side effects
- on the part of the cardiovascular system: arterial hypotension, AV block II and III degree, sinoatrial blockade, sinus bradycardia, bradyarrhythmic form of atrial fibrillation, asystole, palpitations, tachycardia, development of symptoms of heart failure; rarely - angina pectoris, the development of myocardial infarction (more often with severe obstructive coronary artery disease);
- from the digestive system: abdominal pain or discomfort, nausea, vomiting, constipation, intestinal obstruction, increased activity of hepatic transaminases and alkaline phosphatase; rarely diarrhea;
- from the nervous system: rarely - drowsiness, headache, fatigue, dizziness, lethargy, paresthesia, increased nervous irritability; very rarely - anxiety, fainting, asthenia, extrapyramidal disorders, depression;
- on the part of the reproductive system: in some cases - impotence, galactorrhea, gynecomastia (are reversible, after drug withdrawal they pass on their own);
- from the musculoskeletal system: very rarely - arthralgia, myalgia;
- allergic reactions: urticaria, exanthema, angioedema, Stevens-Johnson syndrome;
- others: peripheral edema, hot flashes; rarely - an increase in body weight; very rarely - gingival hyperplasia, agranulocytosis.
special instructions
The use of Verogalid EP 240 can be started only after the compensation of heart failure.
Epinephrine and isoproterenol should not be used to increase blood pressure in hypertrophic cardiomyopathy; alpha-adrenergic agonists (phenylephrine) should be used.
It is not recommended to stop taking pills suddenly.
Treatment should be accompanied by monitoring the function of the cardiovascular and respiratory systems, the volume of circulating blood, the level of electrolytes and glucose in the blood plasma, the amount of urine excreted.
Atrial fibrillation or atrial flutter in patients with WPW syndrome may cause ventricular tachycardia.
Drug interactions
With the simultaneous use of Verogalide EP 240:
- carbamazepine enhances its effect, this leads to an increased risk of toxic damage to the nervous system;
- rifampicin, phenobarbital reduce the effectiveness of verapamil;
- cimetidine enhances the effect of the drug by lowering hepatic metabolism and increasing the bioavailability of verapamil;
- nicotine accelerates metabolic processes in the liver, reducing the concentration of verapamil in the blood;
- inhalation anesthetics increase the risk of developing AV blockade, bradycardia, heart failure;
- beta-blockers can potentiate the negative inotropic effect, increasing the risk of developing bradycardia, AV conduction disorders;
- digoxin, theophylline, cyclosporine, quinidine increase their concentration in the blood;
- lithium preparations, taken for a long time by patients, can reduce their level of concentration in blood serum;
- atorvastatin, lovastatin (lipid-lowering agents) increase their serum levels;
- simvastatin increases its total plasma concentration (AUC) by about 2.6 times;
- grapefruit juice can increase the AUC and C max of verapamil;
- acetylsalicylic acid can cause increased bleeding;
- other antihypertensive drugs enhance their effect;
- almotriptan, glyburide can reduce their concentration in the blood;
- St. John's wort may help reduce the AUC of verapamil.
In progressive neoplasms, verapamil does not affect the clearance or level of doxorubicin, and in small cell lung cancer it helps to reduce the T 1/2 and C max of doxorubicin.
The metabolism of pravastatin, fluvastatin and rosuvastatin takes place without the influence of CYP3A4 isoenzymes, therefore their interaction with the drug is least likely.
Against the background of the use of verapamil, HMG-CoA reductase inhibitors should be prescribed in the lowest doses, then they can be gradually increased. If the patient is already taking HMG-CoA reductase inhibitors, then when prescribing verapamil, the dose of the inhibitor must be adjusted taking into account the level of serum cholesterol concentration.
Analogs
Analogs of Verogalide EP 240 are: Verapamil, Isoptin, Finoptin, Isoptin SR 240.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C, protected from moisture and light.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
