سعر ايزوبتوميل اس ار 240 مجم 10 اقراص 2022

Verapamil 240 mg sustained-release tablets (pack of 10) by Arab Drug Company (ADCO), Egypt; a once- or twice-daily calcium channel blocker used mainly for hypertension.

• Hypertension, to lower blood pressurePopulation: AdultsDailyMed (US National Library of Medicine)

• Most frequent adverse reactions in clinical trials (4,954 patients): constipation 7.3%, dizziness 3.3%, nausea 2.7%, hypotension 2.5%, headache 2.2%, oedema 1.9%, heart failure/pulmonary oedema 1.8%, fatigue 1.7%, dyspnoea 1.4%, bradycardia 1.4%, AV block 1.2%, rash 1.2%, flushing 0.6%; elevated liver enzymes and reversible paralytic ileus have also been reported.International label, same formulation · DailyMed (US National Library of Medicine)

• Contraindicated in severe left ventricular dysfunction; hypotension (systolic pressure below 90 mm Hg) or cardiogenic shock; sick sinus syndrome or second- or third-degree AV block (except with a functioning artificial ventricular pacemaker); atrial flutter or fibrillation with an accessory bypass tract (e.g. Wolff-Parkinson-White, Lown-Ganong-Levine syndromes); and known hypersensitivity to verapamil.International label, same formulation · DailyMed (US National Library of Medicine)

• Heart failure: verapamil has a negative inotropic effect; avoid in severe left ventricular dysfunction (e.g. ejection fraction below 30%) or moderate to severe heart failure, and in any degree of ventricular dysfunction in patients receiving a beta-blocker.International label, same formulation · DailyMed (US National Library of Medicine)
• Hypotension, AV block and bradycardia may occur; marked first-degree or progression to second- or third-degree AV block requires dose reduction or discontinuation.International label, same formulation · DailyMed (US National Library of Medicine)
• Elevated liver enzymes and cases of hepatocellular injury have been reported; periodic monitoring of liver function is prudent.International label, same formulation · DailyMed (US National Library of Medicine)

• CYP3A4 inhibitors (e.g. erythromycin, ritonavir) and inducers (e.g. rifampin)CYP3A4 inhibitors have raised and CYP3A4 inducers have lowered verapamil plasma levels.DailyMed (US National Library of Medicine)
• Simvastatin, lovastatin and other CYP3A4-metabolised statinsCombination has been associated with myopathy/rhabdomyolysis; limit simvastatin to 10 mg daily and lovastatin to 40 mg daily; lower doses of other CYP3A4 substrates (e.g. atorvastatin) may be needed.DailyMed (US National Library of Medicine)
• Beta-adrenergic blockersConcomitant use may have additive negative effects on heart rate, AV conduction and contractility; close surveillance is needed and the combination should usually be avoided in AV conduction abnormalities or depressed left ventricular function.DailyMed (US National Library of Medicine)

• There are no adequate and well-controlled studies in pregnant women; animal studies showed no teratogenicity but embryocidal effects and retarded fetal growth at maternally toxic doses; use during pregnancy only if clearly needed. Verapamil crosses the placenta.International label, same formulation · DailyMed (US National Library of Medicine)
• Verapamil is excreted in human milk; because of potential adverse reactions in nursing infants, nursing should be discontinued while verapamil is administered.International label, same formulation · DailyMed (US National Library of Medicine)

• Verapamil: Inhibits calcium ion influx through slow channels in cardiac and vascular smooth muscle, slowing AV-node conduction and reducing myocardial contractility and peripheral vascular resistance.