Veracal SR 180 mg Tablet contains Verapamil Hydrochloride in a sustained-release (SR) formulation, designed to provide prolonged and consistent therapeutic effects throughout the day. Verapamil is a well-known calcium channel blocker used extensively in the treatment of cardiovascular disorders such as hypertension, angina pectoris, and supraventricular arrhythmias. The sustained-release formulation helps maintain stable plasma concentrations, improves patient compliance, and reduces the need for frequent dosing.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Calcium-channel blockers

Pharmacology

Verapamil acts by inhibiting the entry of calcium ions into slow calcium channels and voltage-sensitive areas of vascular smooth muscle and myocardial cells during depolarization. Calcium ions play a vital role in myocardial contraction and cardiac conduction. By limiting calcium influx, verapamil relaxes coronary and peripheral vascular smooth muscle, leading to coronary vasodilation and reduced peripheral resistance. It also slows automaticity and atrioventricular (AV) nodal conduction, resulting in a reduced heart rate and improved myocardial oxygen balance. These pharmacological effects make Veracal SR 180 mg effective in controlling blood pressure, reducing anginal symptoms, and managing supraventricular arrhythmias.

Indications

Veracal SR 180 mg Tablet is indicated for the treatment of:

• Essential hypertension

• Angina pectoris and prevention of re-infarction

• Supraventricular arrhythmias

Verapamil injection (where applicable) is additionally indicated in:

• Paroxysmal supraventricular tachycardia

• Atrial fibrillation with rapid ventricular response (except in Wolff-Parkinson-White syndrome)

• Atrial flutter with rapid conduction

• Extrasystoles

• Acute hypertension and acute coronary insufficiency

• Prophylaxis and treatment of ectopic arrhythmias, particularly ventricular extrasystoles during halothane anesthesia or during the use of adrenaline

Dosage and Administration

The dosage of Veracal SR 180 mg should be individualized according to patient response and clinical condition. The tablet should be taken with food and swallowed whole without crushing or chewing.

For essential hypertension, the usual initial dose is 180 mg once daily in the morning. If blood pressure control is inadequate, the dose may be titrated to:

• 240 mg once daily

• 180 mg in the morning plus 180 mg in the evening

• 240 mg every 12 hours

For angina pectoris, the usual total daily dose ranges from 240 mg to 360 mg in divided doses.
For supraventricular arrhythmias in digitalized patients, 240 mg to 360 mg daily in divided doses may be required, depending on disease severity.

Dose adjustments should always be made under medical supervision.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Drug Interactions

Verapamil may interact with numerous medications. Plasma levels may increase with CYP3A4 inhibitors such as erythromycin, ritonavir, and cimetidine, while CYP3A4 inducers like rifampicin and phenobarbital may reduce its effectiveness. Verapamil can increase plasma concentrations of digoxin, beta-blockers, statins, immunosuppressants, lithium, and several other drugs. Concomitant use with antihypertensives, diuretics, or vasodilators may enhance hypotensive effects.

Contraindications

Veracal SR 180 mg is contraindicated in patients with:

• Severe left ventricular dysfunction

• Hypotension or cardiogenic shock

• Sick sinus syndrome without a pacemaker

• Second- or third-degree AV block without a pacemaker

• Atrial fibrillation or flutter with accessory pathways (e.g. WPW syndrome)

• Known hypersensitivity to verapamil

Side Effects

Verapamil is generally well tolerated. Common side effects include constipation, nausea, dizziness, headache, fatigue, hypotension, bradycardia, edema, skin rash, and elevated liver enzymes.

Pregnancy and Lactation

Verapamil should be used during pregnancy only if clearly needed, as it may cause fetal hypoxia due to maternal hypotension. The drug is excreted in breast milk; therefore, breastfeeding should be discontinued during treatment.

Storage

Store below 30°C. Protect from light and moisture. Keep out of reach of children.