Verapamil Hydrochloride 2.5 mg/mL Injection, Solution
Other active recalls for Verapamil Hydrochloride (different manufacturers) — 2 · tap to view
🆔 Identity & classification
Where does this data come from?
🏷️ RxNorm drug class
This medicine belongs to the Calcium Channel Blocker class.
Where does this data come from?
🏭 Manufacturer & labeler
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🩺 Clinical
- That depends on why your doctor prescribed it. Verapamil can treat three main problems: high blood pressure, angina (chest pain from the heart not getting enough blood), and certai...
- What exactly is verapamil treating in my body?
- Yes, and it depends on your specific formulation. If you have the extended-release tablets, take them in the morning with food. If you have the extended-release PM capsules, take t...
- Does it matter when I take verapamil or whether I take it with food?
Patient education
Supplement & herbal interactions
Verapamil may be associated with lower levels of 2 nutrients — worth a chat with your pharmacist, not a cause for alarm.
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Ask a licensed pharmacist directly — free, answered by our team.
💊 What it looks like
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🧪 Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.
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UNII QTT17582CB
A strong acid used to adjust and maintain the proper pH level in liquid medicines, ensuring stability and preventing breakdown of active ingredients.
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8.5 mg / 1 mL
UNII 451W47IQ8X
Sodium chloride is common table salt. It's used in medicines as a buffer to maintain proper pH, as a filler to add bulk, or to adjust the osmotic balance in liquid formulations.
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UNII 55X04QC32I
A strong alkaline chemical used to adjust and maintain the pH balance of liquid medicines. It helps keep the medicine stable and ensures it stays effective during storage.
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UNII 059QF0KO0R
Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.
4 inactive ingredients listed in the exact product block matched to this NDC.
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ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
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💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per mL | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | Not in the retail survey — common for institutional, discontinued, or low-volume packs. | |
| Medicaid paysCMS SDUD · 12 mo | $6.50 | $324.93 / 50 ml |
| Medicare drug plans payPart D · quarterly | No Part D plan price is available for this NDC in our data. | |
Where does this data come from?
🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Verapamil Hydrochloride 2.5 mg/mL 00404-9966-02 | Henry | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 00409-1144-02 | Hospira, | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 00409-4011-01 | Hospira, | 5 ampules | — | AP | FDA listed | — |
| Verapamil hydrochloride 2.5 mg/mL 23155-0911-41 | Heritage | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 25021-0312-02 | Sagent | 25 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 42571-0313-75 | Micro | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 43066-0031-25 | Baxter | 25 vials | — | AP | FDA listed | — |
| Verapamil Hci 2.5 mg/mL 51662-1269-01 | HF | 2 ml | — | AP | FDA listed | — |
| Verapamil Hci 2.5 mg/mL 51662-1442-01 | HF | 2 ml | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 51662-1549-01 | HF | 2 ml | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 51662-1686-03 | HF | 25 pouches | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 51754-0203-02 | EXELA | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 51754-0204-02 | EXELA | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 55150-0342-01 | Eugia | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 65145-0113-25 | Caplin | 25 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 65219-0384-02 | FRESENIUS | 25 vials | — | AP | FDA listed | — |
| Verapamil hydrochloride 2.5 mg/mL 68083-0447-25 | Gland | 25 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mLthis 70069-0271-25 | Somerset | 25 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70069-0273-05 | Somerset | 5 ampules | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70121-1585-05 | Amneal | 25 vials | — | — | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70518-4453-00 | REMEDYREPACK | 25 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70710-1643-07 | Zydus | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70710-1937-07 | Zydus | 5 vials | — | AP | FDA listed | — |
| verapamil hydrochloride 2.5 mg/mL 70756-0605-25 | Lifestar | 25 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70771-1601-07 | Zydus | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 71872-7048-01 | Medical | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 71872-7183-01 | Medical | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 5 mg/2mL 71872-7203-01 | Medical | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 5 mg/2mL 71872-7210-01 | Medical | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 71872-7243-01 | Medical | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 71872-7291-01 | Medical | 1 vial | — | AP | FDA listed | — |
| verapamil hydrochloride 2.5 mg/mL 71872-7356-01 | Medical | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 5 mg/2mL 72485-0108-05 | Armas | 5 vials | — | AP | FDA listed | — |
| verapamil hydrochloride 2.5 mg/mL 84549-0605-25 | ProPharma | 2 ml | — | AP | FDA listed | — |
| Verapamil hydrochloride 2.5 mg/mL 68083-0448-05 | Gland | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70771-1602-05 | Zydus | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 55150-0343-01 | Eugia | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70069-0272-05 | Somerset | 5 vials | — | AP | FDA listed | — |
| verapamil hydrochloride 2.5 mg/mL 70756-0606-05 | Lifestar | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 00404-9967-04 | Henry | 1 vial | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 43066-0035-05 | Baxter | 5 vials | — | AP | FDA listed | — |
| Verapamil hydrochloride 2.5 mg/mL 23155-0912-41 | Heritage | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 65145-0114-05 | Caplin | 5 vials | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70121-1586-03 | Amneal | 5 vials | — | — | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 51662-1270-01 | HF | 1 syringe | — | — | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 00404-9968-04 | Henry | 1 syringe | — | — | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 51662-1398-01 | HF | 4 ml | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 51662-1685-01 | HF | 4 ml | — | AP | FDA listed | — |
| Verapamil Hydrochloride 2.5 mg/mL 70710-1644-05 | Zydus | 5 vials | — | AP | FDA listed | — |
Where does this data come from?
⏳ Availability & generic status
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
Where does this data come from?
🗺️ Medicaid utilization & spend
💊 Medicaid utilization by pack size
🔬 Reported adverse events (FAERS)
Top reported reactions
Reporter sex
Serious outcomes
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📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 70069-0271-05 | 5 VIAL in 1 CARTON (70069-271-05) / 2 mL in 1 VIAL (70069-271-01) | 2018-06-18 | Active |
| 70069-0271-25 You're viewing this | 25 VIAL in 1 CARTON (70069-271-25) / 2 mL in 1 VIAL | 2018-06-18 | Active |
In Medicaid, this is the most-dispensed pack of this product — about 81% of fills over the last four reported quarters. See all packs ↓
Pack size FAQ
What quantity is in NDC 70069-0271-25?
What NDC number is used to bill for this package of Verapamil Hydrochloride 2.5 mg/mL Injection, Solution?
🧭 About this NDC listing & data coverage
What data is (and isn’t) available for this NDC — tap to expand
| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | ✓ Available |
| Package photos | ✓ Available |
| Inactive ingredients (structured) | ✓ Available |
| NADAC pharmacy acquisition price (CMS) | — Not published for this NDC CMS publishes NADAC only for NDCs reported in its retail-pharmacy survey. |
| Orange Book / therapeutic-equivalence data | ✓ Available |
| HCPCS J-code billing crosswalk | — Not published for this NDC Most self-administered / retail products have no J-code — that is normal. |
| Medicaid utilization (CMS SDUD) | ✓ Available |
Questions about this listing
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📄 Full prescribing information FDA SPL
🎯 Indications and Usage ▾
INDICATIONS AND USAGE Verapamil Hydrochloride Injection, USP is indicated for the following: Rapid conversion to sinus rhythm of paroxysmal supraventricular tachycardias, including those associated with accessory bypass tracts (Wolff-Parkinson-White [W-P-W] and Lown-Ganong-Levine [L-G-L] syndromes). When clinically advisable, appropriate vagal maneuvers (e.g., Valsalva maneuver) should be attempted prior to verapamil hydrochloride administration. Temporary control of rapid ventricular rate in atrial flutter or atrial fibrillation except when the atrial flutter and/or atrial fibrillation are associated with accessory bypass tracts (Wolff-Parkinson-White (W-P-W) and Lown-Ganong-Levine (L-G-L) syndromes).
In controlled studies in the United States, about 60% of patients with supraventricular tachycardia converted to normal sinus rhythm within 10 minutes after intravenous verapamil hydrochloride. Uncontrolled studies reported in the world literature describe a conversion rate of about 80%. About 70% of patients with atrial flutter and/or fibrillation with a faster ventricular rate respond with a decrease in ventricular rate of at least 20%.
Conversion of atrial flutter or fibrillation to sinus rhythm is uncommon (about 10%) after verapamil hydrochloride and may reflect the spontaneous conversion rate, since the conversion rate after placebo was similar. Slowing of the ventricular rate in patients with atrial fibrillation/flutter lasts 30 to 60 minutes after a single injection. Because a small fraction (<1%) of patients treated with verapamil hydrochloride respond with life-threatening adverse responses (rapid ventricular rate in atrial flutter/fibrillation, and an accessory bypass tract, marked hypotension, or extreme bradycardia/asystole - see CONTRAINDICATIONS and WARNINGS ), the initial use of verapamil hydrochloride injection should, if possible, be in a treatment setting with monitoring and resuscitation facilities , including D.C.-cardioversion capability (see ADVERSE REACTIONS , Suggested Treatment of Acute Cardiovascular Adverse Reactions).
As familiarity with the patient's response is gained, use in an office setting may be acceptable. Cardioversion has been used safely and effectively after verapamil hydrochloride injection.
⏱️ Dosage and Administration ▾
DOSAGE AND ADMINISTRATION FOR INTRAVENOUS USE ONLY. VERAPAMIL HYDROCHLORIDE INJECTION SHOULD BE GIVEN AS A SLOW INTRAVENOUS INJECTION OVER AT LEAST A TWO-MINUTE PERIOD OF TIME UNDER CONTINUOUS ELECTROCARDIOGRAPHIC (ECG) AND BLOOD PRESSURE MONITORING. The recommended intravenous doses of verapamil hydrochloride injection are as follows: Adult: Initial dose - 5 to 10 mg (0.075 to 0.15 mg/kg body weight) given as an intravenous bolus over at least 2 minutes.
Repeat dose - 10 mg (0.15 mg/kg body weight) 30 minutes after the first dose if the initial response is not adequate. An optimal interval for subsequent intravenous doses has not been determined, and should be individualized for each patient. Older patients - The dose should be administered over at least 3 minutes to minimize the risk of untoward drug effects.
Pediatric: Initial dose: 0 to 1 year: 0.1 to 0.2 mg/kg body weight (usual single dose range: 0.75 to 2 mg) should be administered as an intravenous bolus over at least 2 minutes under continuous ECG monitoring. 1 to 15 years : 0.1 to 0.3 mg/kg body weight (usual single dose range: 2 to 5 mg) should be administered as an intravenous bolus over at least 2 minutes. Do not exceed 5 mg.
Repeat dose: 0 to 1 year: 0.1 to 0.2 mg/kg body weight (usual single dose range: 0.75 to 2 mg) 30 minutes after the first dose if the initial response is not adequate ( under continuous ECG monitoring ). An optimal interval for subsequent intravenous doses has not been determined, and should be individualized for each patient. 1 to 15 years: 0.1 to 0.3 mg/kg body weight (usual single dose range: 2 to 5 mg) 30 minutes after the first dose if the initial response is not adequate.
Do not exceed 10 mg as a single dose. An optimal interval for subsequent intravenous doses has not been determined, and should be individualized for each patient. Note: Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Use only if solution is clear and vial seal is intact. Unused amount of solution should be discarded immediately following withdrawal of any portion of contents. For stability reasons this product is not recommended for dilution with Sodium Lactate Injection, USP in polyvinyl chloride bags.
Verapamil is physically compatible and chemically stable for at least 24 hours at 25°C protected from light in most common large volume parenteral solutions. Admixing verapamil hydrochloride injection with albumin, amphoteric in B, hydralazine hydrochloride and trimethoprim with sulfamethoxazole should be avoided. Verapamil hydrochloride injection will precipitate in any solution with a pH above 6.0.
⛔ Contraindications ▾
CONTRAINDICATIONS Verapamil hydrochloride injection is contraindicated in: Severe hypotension or cardiogenic shock. Second- or third-degree AV block (except in patients with a functioning artificial ventricular pacemaker). Sick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker).
Severe congestive heart failure (unless secondary to a supraventricular tachycardia amenable to verapamil therapy). Patients receiving intravenous beta-adrenergic blocking drugs (e.g., propranolol). Intravenous verapamil and intravenous beta-adrenergic blocking drugs should not be administered in close proximity to each other (within a few hours), since both may have a depressant effect on myocardial contractility and AV conduction.
Patients with atrial flutter or atrial fibrillation and an accessory bypass tract (e.g., Wolff- Parkinson-White, Lown-Ganong-Levine syndromes) are at risk to develop ventricular tachyarrhythmia including ventricular fibrillation if verapamil is administered. Therefore, the use of verapamil in these patients is contraindicated. Ventricular tachycardia: Administration of intravenous verapamil to patients with wide-complex ventricular tachycardia (QRS ≥ 0.12 sec) can result in marked hemodynamic deterioration and ventricular fibrillation.
Proper pretherapy diagnosis and differentiation from wide-complex supraventricular tachycardia is imperative in the emergency room setting. Known hypersensitivity to verapamil hydrochloride.
⚠️ Warnings ▾
WARNINGS VERAPAMIL HYDROCHLORIDE SHOULD BE GIVEN AS A SLOW INTRAVENOUS INJECTION OVER AT LEAST A TWO-MINUTE PERIOD OF TIME (see DOSAGE AND ADMINISTRATION ). Hypotension: Verapamil hydrochloride injection often produces a decrease in blood pressure below baseline levels that is usually transient and asymptomatic but may result in dizziness. Systolic pressure less than 90 mm Hg and/or diastolic pressure less than 60 mm Hg was seen in 5% to 10% of patients in controlled U.S. trials in supraventricular tachycardia and in about 10% of the patients with atrial flutter/fibrillation.
The incidence of symptomatic hypotension observed in studies conducted in the U.S. was approximately 1.5%. Three of the five symptomatic patients required intravenous pharmacologic treatment (norepinephrine bitartrate, metaraminol bitartrate, or 10% calcium gluconate). All recovered without sequelae.
Extreme Bradycardia/Asystole: Verapamil hydrochloride affects the AV and SA nodes and rarely may produce second- or third-degree AV block, bradycardia, and, in extreme cases, asystole. This is more likely to occur in patients with a sick sinus syndrome (SA nodal disease), which is more common in older patients. Bradycardia associated with sick sinus syndrome was reported in 0.3% of the patients treated in controlled double-blind trials in the U.S.
The total incidence of bradycardia (ventricular rate less than 60 beats/min) was 1.2% in these studies. Asystole in patients other than those with sick sinus syndrome is usually of short duration (few seconds or less), with spontaneous return to AV nodal or normal sinus rhythm. If this does not occur promptly, appropriate treatment should be initiated immediately.
(See ADVERSE REACTIONS and Suggested Treatment of Acute Cardiovascular Adverse Reactions .) Heart Failure: When heart failure is not severe or rate related, it should be controlled with digitalis glycosides and diuretics, as appropriate, before verapamil is used. In patients with moderately severe to severe cardiac dysfunction (pulmonary wedge pressure above 20 mm Hg, ejection fraction less than 30%), acute worsening of heart failure may be seen. Concomitant Antiarrhythmic Therapy: Digitalis: Verapamil hydrochloride injection has been used concomitantly with digitalis preparations without the occurrence of serious adverse effects.
However, since both drugs slow AV conduction, patients should be monitored for AV block or excessive bradycardia. Procainamide: Intravenous verapamil has been administered to a small number of patients receiving oral procainamide without the occurrence of serious adverse effects. Quinidine: Intravenous verapamil has been administered to a small number of patients receiving oral quinidine without the occurrence of serious adverse effects.
However, three patients have been described in whom the combination resulted in an exaggerated hypotensive response presumably from the combined ability of both drugs to antagonize the effects of catecholamines on α- adrenergic receptors. Caution should therefore be used when employing this combination of drugs. Beta-Adrenergic Blocking Drugs: Verapamil hydrochloride injection has been administered to patients receiving oral beta-blockers without the development of serious adverse effects.
However, since both drugs may depress myocardial contractility and AV conduction, the possibility of detrimental interactions should be considered. The concomitant administration of intravenous beta-blockers and intravenous verapamil has resulted in serious adverse reactions (see CONTRAINDICATIONS ), especially in patients with severe cardiomyopathy, congestive heart failure, or recent myocardial infarction. Disopyramide: Until data on possible interactions between verapamil and all forms of disopyramide phosphate are obtained, disopyramide should not be administered within 48 hours before or 24 hours after verapamil administration.
Flecainide: A study in healthy volunteers showed that the concomitant administr…
🤒 Adverse Reactions ▾
ADVERSE REACTIONS The following reactions were reported with verapamil hydrochloride injection used in controlled U.S. clinical trials involving 324 patients: Cardiovascular: Symptomatic hypotension (1.5%); bradycardia (1.2%); severe tachycardia (1.0%). The worldwide experience in open clinical trials in more than 7,900 patients was similar. Central Nervous System Effects: Dizziness (1.2%); headache (1.2%).
Occasional cases of seizures during verapamil injection have been reported. Gastrointestinal: Nausea (0.9%); abdominal discomfort (0.6%). In rare cases of hypersensitive patients, broncho/laryngeal spasm accompanied by itch and urticaria has been reported.
The following reactions have been reported at low frequency: emotional depression, rotary nystagmus, sleepiness, vertigo, muscle fatigue, diaphoresis, and respiratory failure. Suggested Treatment of Acute Cardiovascular Adverse Reactions* The frequency of these adverse reactions was quite low, and experience with their treatment has been limited. Adverse Reaction Proven Effective Treatment Supportive Treatment 1.
Symptomatic hypotension requiring treatment Dopamine intravenous Calcium chloride intravenous Norepinephrine bitartrate intravenous Metaraminol bitartrate intravenous Isoproterenol HCl intravenous Intravenous fluids Trendelenburg position 2. Bradycardia, AV block, Asystole Isoproterenol HCl intravenous Calcium chloride intravenous Norepinephrine bitartrate intravenous Atropine intravenous Cardiac pacing Intravenous fluids (slow drip) 3. Rapid ventricular rate (due to antegrade conduction in flutter/fibrillation with W-P-W or L-G-L syndromes) DC-cardioversion (high energy may be required) Procainamide intravenous Lidocaine intravenous Intravenous fluids (slow drip) *Actual treatment and dosage should depend on the severity of the clinical situation and the judgment and experience of the treating physician.
🤰 Pregnancy ▾
Pregnancy: Teratogenic Effects: Reproduction studies have been performed in rabbits and rats at oral verapamil doses up to 1.5 (15 mg/kg/day) and 6 (60 mg/kg/day) times the human oral daily dose, respectively, and have revealed no evidence of teratogenicity. In the rat, this multiple of the human dose was embryocidal and retarded fetal growth and development, probably because of adverse maternal effects reflected in reduced weight gains of the dams. This oral dose has also been shown to cause hypotension in rats.
There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
🧒 Pediatric Use ▾
Pediatric Use: Controlled studies with verapamil have not been conducted in pediatric patients, but uncontrolled experience with intravenous administration in more than 250 patients, about half under 12 months of age and about 25% newborn, indicates that results of treatment are similar to those in adults. In rare instances, however, severe hemodynamic side effects - some of them fatal - have occurred following the intravenous administration of verapamil to neonates and infants. Caution should therefore be used when administering verapamil to this group of pediatric patients.
The most commonly used single doses in patients up to 12 months of age have ranged from 0.1 to 0.2 mg/kg of body weight, while in patients aged 1 to 15 years, the most commonly used single doses ranged from 0.1 to 0.3 mg/kg of body weight. Most of the patients received the lower dose of 0.1 mg/kg once, but in some cases, the dose was repeated once or twice every 10 to 30 minutes.
🆘 Overdosage ▾
OVERDOSAGE Treatment of overdosage should be supportive and individualized. Beta-adrenergic stimulation and/or parenteral administration of calcium solutions may increase calcium injections ion flux across the slow channel, and have been effectively used in treatment of deliberate overdosage with oral verapamil hydrochloride. Verapamil cannot be removed by hemodialysis.
Clinically significant hypotensive reactions or high-degree AV block should be treated with vasopressor agents or cardiac pacing, respectively. Asystole should be handled by the usual measures including isoproterenol hydrochloride, other vasopressor agents, or cardiopulmonary resuscitation (see ADVERSE REACTIONS: Suggested Treatment of Acute Cardiovascular Adverse Reactions).
🧬 Clinical Pharmacology ▾
CLINICAL PHARMACOLOGY Mechanism of Action: Verapamil inhibits the calcium ion (and possibly sodium ion) influx through slow channels into conductile and contractile myocardial cells and vascular smooth muscle cells. The antiarrhythmic effect of verapamil appears to be due to its effect on the slow channel in cells of the cardiac conduction system. The vasodilatory effect of verapamil appears to be due to its effect on blockade of calcium channels as well as α receptors.
In the isolated rabbit heart, concentrations of verapamil that markedly affect SA nodal fibers or fibers in the upper and middle regions of the AV node have very little effect on fibers in the lower AV node (NH region) and no effect on atrial action potentials or His bundle fibers. Electrical activity in the SA and AV nodes depends, to a large degree, upon calcium influx through the slow channel. By inhibiting this influx, verapamil slows AV conduction and prolongs the effective refractory period within the AV node in a rate-related manner.
This effect results in a reduction of the ventricular rate in patients with atrial flutter and/or atrial fibrillation and a rapid ventricular response. By interrupting reentry at the AV node, verapamil can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardias (PSVT), including PSVT associated with Wolff-Parkinson-White syndrome. Verapamil does not induce peripheral arterial spasm.
Verapamil has a local anesthetic action that is 1.6 times that of procaine on an equimolar basis. It is not known whether this action is important at the doses used in man. Verapamil does not alter total serum calcium levels.
Hemodynamics: Verapamil reduces afterload and myocardial contractility. The commonly used intravenous doses of 5 to 10 mg verapamil hydrochloride produce transient, usually asymptomatic, reduction in normal systemic arterial pressure, systemic vascular resistance and contractility; left ventricular filling pressure is slightly increased. In most patients, including those with organic cardiac disease, the negative inotropic action of verapamil is countered by reduction of afterload, and cardiac index is usually not reduced.
However, in patients with moderately severe to severe cardiac dysfunction (pulmonary wedge pressure above 20 mm Hg, ejection fraction less than 30%), acute worsening of heart failure may be seen. Peak therapeutic effects occur within 3 to 5 minutes after a bolus injection. Pharmacokinetics: Intravenously administered verapamil hydrochloride has been shown to be rapidly metabolized.
Following intravenous infusion in man, verapamil is eliminated bi-exponentially, with a rapid early distribution phase (half-life about 4 minutes) and a slower terminal elimination phase (half- life 2 to 5 hours). In healthy men, orally administered verapamil hydrochloride undergoes extensive metabolism in the liver, with 12 metabolites having been identified, most in only trace amounts. The major metabolites have been identified as various N- and O-dealkylated products of verapamil.
Approximately 70% of an administered dose is excreted in the urine and 16% more in the feces within 5 days. About 3% to 4% is excreted as unchanged drug. Aging may affect the pharmacokinetics of verapamil given to hypertensive patients.
Elimination half-life may be prolonged in the elderly.
📦 How Supplied / Storage and Handling ▾
HOW SUPPLIED Verapamil Hydrochloride Injection, USP 2.5 mg/mL is supplied in single-dose containers as follows: NDC No. Container Volume Total Content/container 70069- 272 -05 Single-dose Vial 4 mL (5 pack carton) 10 mg 70069- 272 -25 Single-dose Vial 4 mL (25 pack carton) 10 mg 70069- 271 -25 Single-dose Vial 2 mL (25 pack carton) 5 mg 70069- 271 -05 Single-dose Vial 2 mL (5 pack carton) 5 mg 70069- 273 -05 Ampule 2 mL (5 pack tray) 5 mg Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature]. Protect from light by retaining in package until ready to use.
For Product Inquiry call +1-800-417-9175 Manufactured for: Somerset Therapeutics, LLC Somerset, NJ 08873 Made in India Code No.: KR/DRUGS/KTK/28/289/97 1201382 ST-VRP/P/03 Revised: November, 2025
📋 Description ▾
DESCRIPTION Verapamil hydrochloride is a calcium antagonist or slow-channel inhibitor. Verapamil Hydrochloride Injection, USP is a sterile, nonpyrogenic solution containing verapamil hydrochloride 2.5 mg/mL and sodium chloride 8.5 mg/mL in water for injection. The solution contains no bacteriostat or antimicrobial agent and is intended for single-dose intravenous administration.
May contain hydrochloric acid and/or sodium hydroxide for pH adjustment; pH is 4.0 to 6.5. The chemical name of Verapamil Hydrochloride, USP is benzeneacetonitrile, α-[3-[{2-(3,4-dimethoxyphenyl)ethyl} methylamino] propyl]-3,4-dimethoxy-α-(1-methylethyl) hydrochloride. Verapamil hydrochloride is a white or practically white crystalline powder.
It is practically odorless and has a bitter taste. It is soluble in water; freely soluble in chloroform; sparingly soluble in alcohol; practically insoluble in ether. It has the following structural formula: Molecular weight: 491.07 Molecular formula: C 27 H 38 N 2 O 4 • HCl Verapamil hydrochloride is not chemically related to other antiarrhythmic drugs.
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