Cardiology · Non-dihydropyridine calcium channel blocker
Verapamil
Dose
IV 2.5–5 mg over 2 min, repeat 5–10 mg after 15–30 min (max 20 mg). PO 40–120 mg TDS.
Mechanism
L-type Ca block → strong AV nodal slowing and negative inotropy.
Indications
- • SVT (AVNRT)
- • Rate control AF
- • Hypertension
- • Cluster headache prophylaxis
Contraindications
- • Systolic HF
- • AV block
- • WPW
- • Concurrent β-blocker IV
- • Hypotension
Use
AVNRT termination; rate control when β-blocker contraindicated.
Monitoring
HR, BP, ECG.
Side effects
- • Constipation
- • Bradycardia
- • Hypotension
- • Peripheral oedema
Related in WardRound
Supraventricular Tachycardia
Protocol · Vagal → adenosine → DC
AF with WPW (Pre-excited)
Protocol · Avoid AV nodal blockers
Hypertrophic Cardiomyopathy
Topic · Cardiology
Wolff-Parkinson-White
Topic · Cardiology
Paroxysmal SVT (AVNRT/AVRT)
Topic · Cardiology
Calcium Channel Blocker Overdose
Topic · Toxicology
Cluster Headache
Topic · Neurology
Always confirm dose against your local formulary / BNF before prescribing.
