Verapamil

Administration

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

Contraindications

Adverse Reactions

Serious

Common

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

Comments

See Also

References