Veracal SR 240 mg Tablet contains Verapamil Hydrochloride in a sustained-release formulation, developed to ensure prolonged therapeutic action with once-daily or twice-daily dosing. Verapamil is a widely used calcium channel blocker that plays an important role in the management of cardiovascular disorders such as hypertension, angina pectoris, and supraventricular arrhythmias. The sustained-release (SR) formulation provides steady plasma drug levels, improves treatment adherence, and minimizes fluctuations in blood pressure and heart rate.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Calcium-channel blockers

Pharmacology

Verapamil exerts its pharmacological action by inhibiting the entry of calcium ions into slow L-type calcium channels located in myocardial cells and vascular smooth muscle during depolarization. Calcium ions are essential for myocardial contraction and electrical impulse conduction through the atrioventricular (AV) node. By reducing calcium influx, verapamil relaxes coronary and peripheral vascular smooth muscle, resulting in coronary vasodilation and reduced systemic vascular resistance. It also slows sinus node automaticity and AV nodal conduction, leading to a decrease in heart rate and myocardial oxygen demand. These combined effects make Veracal SR 240 mg effective in controlling blood pressure, relieving anginal symptoms, and managing supraventricular arrhythmias.

Indications

Veracal SR 240 mg Tablet is indicated for the treatment of:

• Essential hypertension

• Angina pectoris and prevention of re-infarction

• Supraventricular arrhythmias

Verapamil injection (when clinically required) is additionally indicated for:

• 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 adrenaline administration

Dosage and Administration

The dosage of Veracal SR 240 mg should be individualized by careful titration based on 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 adequate blood pressure control is not achieved, the dose may be adjusted 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 the severity of the condition. All dose adjustments should be made under medical supervision.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Drug Interactions

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

Contraindications

Veracal SR 240 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, peripheral edema, skin rash, and transient elevation of liver enzymes.

Pregnancy and Lactation

Verapamil should be used during pregnancy only if clearly needed, as it may cause fetal hypoxia associated with 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.