The management of mild to moderate hypertension and renal hypertension, used alone or in combination with other antihypertensive therapy.
For the management and prophylaxis of angina pectoris (including variant angina).
The treatment and prophylaxis of paroxysmal supraventricular tachycardia and the reduction of the ventricular rate in atrial fibrillation/flutter. Verapamil should not be used for atrial fibrillation/flutter in patients with Wolff-Parkinson-White syndrome.
Adults:
Hypertension: initially 120mg twice daily increasing to 160mg twice daily where necessary. In some cases doses of up to 480mg daily, in divided doses, have been used. A further reduction in blood pressure may be obtained by combining verapamil with other antihypertensive agents, in particular diuretics.
Angina: 120mg three times daily is recommended. 80mg three times daily may be completely
Hypersensitivity to the active substance or to any of the excipients.
Hypotension (of less than 90mmHg systolic).
Second or third degree atrioventricular block; sick sinus syndrome (except in patients with a functioning artifical pacemaker); uncompensated heart failure; marked bradycardia (less than 50 beats/minute).
Combination with beta-blockers is contraindicated in patients with poor ventricular function.
Wolff-Parkinson-White syndrome
Concomitant ingestion of grapefruit juice is contraindicated.
Acute myocardial infarction complicated by bradycardia, marked hypotension or left ventricular failure.
Combination with ivabradine.
