Monograph Details

Cardiovascular System > Hypertension
ISOPTIN SR
Manufacturer
FSC Laboratories
Legal Classification
Rx
Pharmacological Class
Calcium channel blocker (diphenylalkylamine).
Generic Name
Verapamil HCl 120mg, 180mg+, 240mg+; sust-rel tabs; +scored.
Indications
Hypertension.
Children
<18yrs: not recommended.
Adults
Take with food. Initially 120–180mg in the AM. May increase to 240mg in the AM; then 180mg every 12 hrs or 240mg in the AM and 120mg in the evening; then 240mg every 12 hrs.
Contraindications
Severe left ventricular (LV) dysfunction or LV dysfunction treated with β-blockers. Moderate to severe heart failure. Hypotension. Cardiogenic shock. Sick sinus syndrome, 2nd- or 3rd-degree AV block, unless paced. Atrial flutter or fibrillation and an accessory bypass tract.
Precautions
Control mild heart failure (eg, with digitalis, diuretics). AV conduction or neuromuscular transmission disorders. Hepatic or renal dysfunction. Monitor liver function. Hypertrophic cardiomyopathy. Pregnancy (Cat.C). Nursing mothers: not recommended.
Interactions
Potentiates alcohol, β-blockers, other antihypertensives, digitalis, theophylline, neuromuscular blockers, flecainide, carbamazepine, cyclosporine. Potentiated by grapefruit juice. Avoid disopyramide; quinidine in cardiomyopathy. Potentiated by CYP3A4 inhibitors (eg, erythromycin, ritonavir); antagonized by CYP3A4 inducers (eg, rifampin). Inhalation anesthetics may potentiate cardiac depression. May increase bleeding with aspirin. Monitor theophylline, lithium.
Adverse Reactions
Constipation, dizziness, nausea, hypotension, headache, edema, CHF, fatigue, dyspnea, bradycardia, AV block, rash, flushing, elevated hepatic enzymes, paralytic ileus.
How Supplied
120mg, 180mg—100
240mg—100, 500
Additional Resources
Related Prescribing Note