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Verapamil

Isoptin, Verapabene · ATC code C08DA01

Brand names: Isoptin, Verapabene, Verahexal, Fibrocard L.p., Isopamil, Ormil

Key facts
Active substance
Verapamil
ATC code
C08DA01
Authorisation
authorised nationally; no central EU authorisation
Information as of
2026-10-29

Key facts

Verapamil is a calcium channel blocker. Per the US prescribing information, the tablets are used for angina, certain supraventricular arrhythmias and essential hypertension.

What it is used for

  • Angina at rest (vasospastic and unstable angina) and chronic stable angina
  • With digitalis, control of ventricular rate in chronic atrial flutter and/or atrial fibrillation; prophylaxis of repetitive paroxysmal supraventricular tachycardia
  • Essential hypertension

Dosing

  • Individualize by titration; do not exceed 480 mg/day
  • Angina: usually 80 mg to 120 mg three times a day; 40 mg three times a day where an increased response is possible (e.g. elderly, decreased hepatic function)
  • Atrial fibrillation (with digitalis): 240 to 320 mg/day in three or four divided doses; PSVT prophylaxis: 240 to 480 mg/day
  • Hypertension: usually 80 mg three times a day (240 mg/day); no evidence of added effect beyond 360 mg; consider starting at 40 mg three times a day in the elderly or people of small stature
  • Severe hepatic dysfunction: about 30% of the usual dose

Contraindications

  • Severe left ventricular dysfunction
  • Hypotension (systolic pressure less than 90 mm Hg) or cardiogenic shock
  • Sick sinus syndrome or second- or third-degree AV block, unless a functioning ventricular pacemaker is present
  • Atrial flutter/fibrillation with an accessory bypass tract (e.g. Wolff-Parkinson-White, Lown-Ganong-Levine)
  • Known hypersensitivity to verapamil

Important warnings

  • Heart failure or pulmonary edema (1.8% in trials); avoid in severe left ventricular dysfunction and with beta-blockers in any ventricular dysfunction
  • Hypotension (2.5%), possibly with dizziness
  • Elevated liver enzymes and hepatocellular injury; periodic liver function monitoring is prudent
  • AV block and bradycardia; rapid ventricular response with an accessory pathway
  • Decreased neuromuscular transmission (e.g. Duchenne muscular dystrophy, myasthenia gravis)

Side effects

  • Constipation (7.30%), dizziness (3.30%), nausea (2.70%), hypotension (2.50%), headache (2.20%), edema (1.90%), fatigue (1.70%)
  • Bradycardia, AV block, dyspnea, rash, flushing
  • Serious: heart failure, AV block, liver injury

Interactions

  • CYP3A4 inhibitors (e.g. erythromycin, ritonavir) raise and inducers (e.g. rifampin) lower verapamil levels
  • Statins that are CYP3A4 substrates: risk of myopathy/rhabdomyolysis; dose limits – see the full text
  • Beta-blockers: additive effects on heart rate, conduction and contractility; digoxin levels may increase by 50% to 75%
  • Disopyramide not within 48 hours before or 24 hours after; lithium, carbamazepine, ivabradine, alcohol, grapefruit juice – see the full text

Pregnancy and breastfeeding

  • Animal studies showed no teratogenicity but embryocidal effects in rats; see the full text
  • Excreted in breast milk; nursing should be discontinued during treatment

Summary of the official product information, written with AI on 2026-10-29. Every number was checked automatically against the original text. Not reviewed by a physician – the full official text is authoritative.

Full official text →

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For patients

Patient information (US)

This product has no separate US patient information.

Authorisation and brand names by country

Medicines with exactly this active-substance composition, as listed in the national registers – alphabetical and without ranking. Whether a product is currently available is not shown here.

Austria

  • IsoptinViatris Austria Gmbh · 4 register entries
  • VerapabeneTeva B.V · 1 register entry

Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-29

Germany

  • IsoptinViatris Healthcare Gmbh · 5 register entries
  • VerahexalHexal Ag · 4 register entries
  • Verapamil1 A Pharma Gmbh, Aliud Pharma Gmbh, Ratiopharm Gmbh, Denk Pharma Gmbh & Co. Kg, Hennig Arzneimittel Gmbh & Co. Kg, Abz-Pharma Gmbh · 11 register entries

Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-29

Turkey

  • Fibrocard L.p.GALEPHARMA İLAÇ SAN. VE TİC. A.Ş. · 2 register entries
  • IsopamilMENARİNİ SAĞLIK VE İLAÇ SAN. TİC. A.Ş. · 1 register entry
  • IsoptinABBOTT LABORATUARLARI İTHALAT İHRACAT VE TİC. LTD. ŞTİ. · 7 register entries
  • OrmilATABAY İLAÇ FABRİKASI A.Ş. · 2 register entries

Source: TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, as of 2026-10-16

Brand names in 26 more European countries
Belgium
Fibrocard, Isoptine, Lodixal
Bulgaria
Верапамил Софарма, Верапамил Чайкафарма, Верогалид Ep, Изокор, Изоптин
Croatia
Isoptin
Cyprus
Akilen, Caveril, Isoptin
Czechia
Isoptin, Verapamil Retard Al, Verogalid Er
Denmark
Isoptin Retard, Veraloc, Veramacor, Verapamil "hexal"
Estonia
Isoptin Retard, Verapamil Ratiopharm
Finland
Isoptin Retard, Veramacor, Verpamil
France
Isoptine, Verapamil L.P. Biogaran, Verapamil L.P. Eg, Verapamil Lp Viatris, Verapamil Sandoz, Verapamil Teva, Vérapamil Viatris
Greece
Isoptin
Hungary
Chinopamil, Isoptin, Verapamil Pannonpharma
Iceland
Isoptin Retard, Veraloc Retard
Ireland
Isoptin, Verap
Italy
Isoptin, Verapamil Doc Generici, Verapamil Eg, Verapamil Hexal
Latvia
Isoptin Retard
Lithuania
Isoptin Retard, Verapamil Ratiopharm
Luxembourg
Isoptin
Malta
Caveril, Isoptin
Netherlands
Isoptin Sr, Verapamil Hcl Cf, Verapamil Hcl Retard Sandoz, Verapamil Hcl Retard Teva, Verapamil Hcl Sandoz, Verapamil Hcl Sr Dexcel, Verapamil Hydrochloride Aurobindo
Norway
Isoptin, Veramacor
Poland
Isoptin, Staveran
Portugal
Isoptin
Romania
Cordamil, Isoptin Rr, Verapamil Arena
Slovakia
Isoptin, Verogalid Er
Spain
Manidón
Sweden
Isoptin, Veramacor Macure

EMA – Article 57 product data (EU/EEA), 2026-10-29

Medelix receives no money from pharmaceutical companies. Brand names are listed alphabetically and without ranking.

Another question about this substance?

Medelix answers clinical questions from guidelines, studies and product information – every claim with its source.

Sources

  1. U.S. Food and Drug Administration. VERAPAMIL HYDROCHLORIDE (AvKARE) – Prescribing Information, 2026-01-15. DailyMed (NLM), 2026-10-29. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a32f346e-71cf-cc11-e053-2a95a90ae88c
  2. EMA – Article 57 product data (EU/EEA), 2026-10-29. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
  3. EMA – Article 57 product data (EU/EEA), 2026-10-29. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
  4. TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, 2026-10-16. https://www.titck.gov.tr/dinamikmodul/85

Editorial: Medelix editorial team · last updated 2026-10-29 · How these pages are made · Report an error

Source: U.S. Food and Drug Administration (FDA), prescribing information, via DailyMed (NLM); public domain. Not advertising, not a treatment recommendation. For questions about your own treatment, ask your doctor or pharmacist.