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Calcium channel blockers – diltiazem cardizem , nicardipine cardene , nifedipine procardia and verapamil calan or isoptin might cause palpitations, swollen ankles edema, constipation, headache or dizziness.

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Antihypertensive AgentsVerapamil administered concomitantly with oral antihypertensive agentse.gvasodilatorsangiotensin-converting enzyme inhibitorsdiureticsbeta blockerswill usually have an additive effect on lowering blood pressurePatients receiving these combinations should be appropriately monitoredConcomitant use of agents that attenuate alpha-adrenergic function with verapamil may result in a reduction in blood pressure that is excessive in some patientsSuch an effect was observed in one study following the concomitant administration of verapamil and prazosin.

Gynecomastia occurred in older male patients on prolonged treatmentand was reversible upon discontinuation of this drugRef]

ISOPTIN has a local anesthetic action that is 1.6 times that of procaine on an equimolar basis.

Use in Patients with Impaired Hepatic FunctionsSince verapamil is highly metabolized by the liverit should be administered cautiously to patients with impaired hepatic functionSevere liver dysfunction prolongs the elimination half-life of immediate release verapamil to about 14 to 16 hourshenceapproximately 30of the dose given to patients with normal liver function should be administered to these patientsCareful monitoring for abnormal prolongation of the PR interval or other signs of excessive pharmacologic effectssee OVERDOSAGEshould be carried out.

CarbamazepineVerapamil may increase carbamazepine concentrations during combined therapyThis may produce carbamazepine side effects such as diplopiaheadacheataxiaor dizziness.

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verapamil hydrochloride verapamil hcl is a calcium ion influx inhibitor slow-channel blocker or calcium ion antagonist available for oral administration in film-coated tablets containing 40 mg, or 120 mg of isoptin sr hydrochloride.