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Miscellaneous Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
As discussed in Chapter 3, verapamil is a calcium channel blocker used as an antiarrhythmic, antihypertensive, and tocolytic agent. No epidemiologic studies on the safety of this agent during pregnancy are published. Maternal hypotension and resultant decreased uterine blood flow are the major risks from the use of this agent.
Cardiovascular system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
8.3. A previously well 3-month-old infant presents with reluctance to feed and breathlessness. The pulse rate is 280/min. Which of the following is/are correct?The most likely diagnosis is supraventricular tachycardia (SVT).Diagnosis of Wolff-Parkinson-White (WPW) syndrome can be confirmed during remission by ECG.Facial immersion in ice water is effective treatment.Verapamil is the recommended treatment in this patient.The infant is unlikely to have relapses.
Effects of Calcium Channel Antagonists on The Myometrium
Published in Gabor Huszar, The Physiology and Biochemistry of the Uterus in Pregnancy and Labor, 2020
Ronald A. Janis, David J. Triggle
Verapamil has been used to reduce the incidence of maternal tachycardia and hypotension caused by β-sympathomimetics, such as ritodrine, used in treatment of preterm labor.160 However, some investigators suggest that the doses of verapamil given to cause tocolysis would produce cardiopression and hypotension in both mother and fetus, since verapamil crosses the placenta. These workers do not recommend the administration of verapamil for this treatment.161
Current advances in the management of cluster headaches
Published in Expert Opinion on Pharmacotherapy, 2021
Theodoros Mavridis, Marianthi Breza, Christina Deligianni, Dimos D. Mitsikostas
Verapamil is a calcium channel blocker and the drug of choice for prophylaxis of CH. There are many trials to support its use [44,45]. The usual initial dose is 240 mg daily. Whereas the recommendations on how to titrate the dosage vary, the best strategy is a slow (~every 2 weeks) increase of the daily dose by 80 mg, even though faster titration may be needed in patients with acute bouts of cluster headache attacks. Usually, response is achieved at 360–480 mg but there are reports of daily doses up to 1200 mg. Whereas it has a Grade C recommendation for prevention of CH [29], the high doses that are usually required for the maximum prophylactic benefit are associated with frequent electrocardiographic abnormalities, such as bradycardia and heart blocks (both asymptomatic and symptomatic) [28]. Gastrointestinal discomfort, constipation, fatigue and gingival hyperplasia are some of verapamil’s other adverse events [27].
Peyronie’s disease – outcomes of collagenase clostridium histolyticum injection: A systematic review
Published in Arab Journal of Urology, 2021
Austin T. Mefford, Omer Raheem, Faysal A. Yafi, Laith M. Alzweri
Verapamil is an L-type calcium channel blocker used in the treatment of hypertension, angina, and heart failure. IL verapamil injection was brought into the spotlight after Levine et al. [21] demonstrated verapamil injection could decrease ‘plaque-associated penile narrowing’ and penile curvature. In a subsequent, and more reputable study, he showed verapamil injection reduced pain in 97% of patients, improved sexual function in 72%, and lessened the degree of curvature and deformity in 54% and 86%, respectively [22]. But other studies have shown IL verapamil to improve sexual function while not having much effect on the size of fibrous plaque [23]. It is for these mixed results and a lack of large-scale placebo-controlled studies that the United States Food and Drug Administration (FDA) has not formally approved verapamil for the treatment of PD.
The first-line cluster headache medication verapamil alters the circadian period and elicits sex-specific sleep changes in mice
Published in Chronobiology International, 2021
Mark J. Burish, Chorong Han, Kazuaki Mawatari, Marvin Wirianto, Eunju Kim, Kaori Ono, Randika Parakramaweera, Zheng Chen, Seung-Hee Yoo
In humans, CH is more common in males at a ratio of 4.3:1 (Fischera et al. 2008). It has been suggested that verapamil is less effective in women, though no systematic studies have been performed (Petersen et al. 2019). In our study, we found that verapamil caused more pronounced disturbances in female sleep, specifically sleep timing (more sleep during the active phase) and quality (decreased sleep bout length). In addition, verapamil also altered the temporal pattern of wheel-running activity in a sex-specific manner, again with more significant changes in female mice. Sleep disturbances are a rare but occasionally documented side effect of verapamil in humans (PDR 2020), though sex-specific differences in sleep disturbances are not clear. Future studies are needed to investigate whether this sexual dimorphism is related to sex-dependent CH disease manifestations and treatment efficacy in humans.