The antihypertensive effect of verapamil, stems from a decreases in peripheral vascular resistance without an increase in heart rate as a reflex response. It has a marked antiarrhythmic effect, particularly in supraventricular arrhythmias. It delays impulse conduction in the A.V. node. Due to Ca-antagonistic effect on the smooth vascular muscles of the coronaries, verapamil ehances myocardial blood flow, even in poststenotic areas, and relieves coronary spasms which contributes to its anti-ischaemic & anti anginal efficacy in all types of coronary artery diseases.

INDICATIONS: Chronic coronary insufficiency, angina pectoris, coronary spasms vasopastic angina, angina after M.I. hypertension. Tachycardias such as paroxysmal supraventricular tachycardia, atrial fibrillation/ flutter with tachyarrhythmia, premature beats.

SPECIAL PRECAUTIONS: Ability to drive or operate machinery may be impaired. Hepatic or renal impairment.

SIDE-EFFECT: Constipation, nausea, vertigo or dizziness headache, flushing, fatigue, nervousness, ankle oedemas, erythromelagia and paresthesia.

DOSAGE: Adults: oral: 40-80 mg 3-4 times a day. Max 480 mg daily.

I.V. 5 mg initially, if desired effect is not achieved, further 5 mg after 5-10 minutes.