VERELAN PM (verapamil hydrochloride)

Verapamil is administered as a racemic mixture of the R and S enantiomers. The systemic concentrations of R and S enantiomers, as well as overall bioavailability, are dependent upon the route of administration and the rate and extent of release from the dosage forms. Upon oral administration, there is rapid stereoselective biotransformation during the first pass of verapamil through the portal circulation. Absorption: In a study in 5 subjects with oral immediate-release verapamil, the systemic b...

Verelan PM was evaluated in two placebo-controlled, parallel design, double-blind studies of patients with mild to moderate hypertension. In the clinical trials, 413 evaluable patients were randomized to either placebo, 100 mg, 200 mg, 300 mg, or 400 mg and treated for up to 8 weeks. Verelan PM or placebo was given once daily between 9 pm and 11 pm (nighttime) and blood pressure changes were measured with 36-hour ambulatory blood pressure monitoring (ABPM). The results of these studies demonstrate that Verelan PM, at 200, 300, and 400 mg, is a consistently and significantly more effective anti...

Most common adverse reactions (incidence ≥ 3% and more common than in patients treated with placebo) are headache, infection, constipation, flu syndrome, peripheral edema, dizziness, pharyngitis, and sinusitis ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Lannett Company, Inc. at 1-844-834-0530 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clini...

Verapamil is contraindicated in: Severe left ventricular dysfunction [see Warnings and Precautions (5.1) ]. Hypotension (less than 90 mm Hg systolic pressure) or cardiogenic shock. Sick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker). Second- or third-degree AV block (except in patients with a functioning artificial ventricular pacemaker). Patients with atr...

Congestive heart failure or pulmonary edema may develop ( 5.1 ) Hypotension/dizziness may occur ( 5.2 ) Elevated transaminases have occurred; monitor liver function ( 5.3 ) Ventricular fibrillation has occurred in patients with atrial flutter or atrial fibrillation and an accessory bypass tract ( 5.4 ) Reduce dose or discontinue therapy if marked first-degree AV block or progression to second- or third-degree AV block occurs ( 5.5 ) Sinus bradycardia, pulmonary edema, severe hypotension, second-...

7 DRUG INTERACTIONS CYP3A4 inhibitors increase verapamil levels ( 7.1 ) CYP3A4 inducers decrease verapamil levels ( 7.1 ) If simvastatin is co-administered with verapamil, do not exceed doses greater than 10 mg daily of simvastatin ( 7.2 ) If lovastatin is co-administered with verapamil, do not exceed doses greater than 40 mg daily of lovastatin ( 7.2 ) Grapefruit juice may significantly increase ...