Isoptin: Advanced Calcium Channel Blockade for Cardiovascular Control
Isoptin
| Product dosage: 120mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.33 | $40.00 (0%) | 🛒 Add to cart |
| 60 | $0.95 | $80.00 $57.00 (29%) | 🛒 Add to cart |
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| 120 | $0.78 | $160.00 $93.00 (42%) | 🛒 Add to cart |
| 180 | $0.71 | $240.00 $127.00 (47%) | 🛒 Add to cart |
| 270 | $0.66 | $360.00 $179.00 (50%) | 🛒 Add to cart |
| 360 |
$0.64
Best per pill
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$480.00 $232.00 (52%) | 🛒 Add to cart |
| Product dosage: 240mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.73 | $52.00 (0%) | 🛒 Add to cart |
| 60 | $1.30 | $104.00 $78.00 (25%) | 🛒 Add to cart |
| 90 | $1.17 | $156.00 $105.00 (33%) | 🛒 Add to cart |
| 120 | $1.08 | $208.00 $130.00 (38%) | 🛒 Add to cart |
| 180 | $1.01 | $312.00 $182.00 (42%) | 🛒 Add to cart |
| 270 | $0.97 | $468.00 $262.00 (44%) | 🛒 Add to cart |
| 360 |
$0.94
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| Product dosage: 40mg | |||
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| Package (num) | Per pill | Price | Buy |
| 60 | $0.72 | $43.00 (0%) | 🛒 Add to cart |
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| 180 | $0.46 | $129.00 $82.00 (36%) | 🛒 Add to cart |
| 270 | $0.41 | $193.50 $110.00 (43%) | 🛒 Add to cart |
| 360 |
$0.39
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Isoptin (verapamil hydrochloride) is a first-line calcium channel blocker indicated for the management of hypertension, angina pectoris, and certain cardiac arrhythmias. As a phenylalkylamine derivative, it exerts potent effects on cardiac and vascular smooth muscle by selectively inhibiting transmembrane calcium influx through L-type channels. This mechanism produces coronary and peripheral vasodilation while reducing myocardial oxygen demand, establishing it as a cornerstone therapy in cardiovascular medicine. Its well-characterized pharmacokinetic profile and extensive clinical evidence support its use in both monotherapy and combination regimens for long-term cardiovascular risk reduction.
Features
- Contains verapamil hydrochloride as the active pharmaceutical ingredient
- Available in immediate-release (80 mg, 120 mg) and sustained-release (120 mg, 180 mg, 240 mg) formulations
- Exhibits high oral bioavailability with extensive hepatic first-pass metabolism
- Demonstrates concentration-dependent calcium channel blockade with negative chronotropic, dromotropic, and inotropic effects
- Shows protein binding of approximately 90% with volume of distribution of 3-5 L/kg
- Undergoes hepatic metabolism via CYP3A4 with renal excretion of metabolites
Benefits
- Effectively reduces systolic and diastolic blood pressure through peripheral vasodilation
- Decreases frequency and severity of angina episodes by improving myocardial oxygen supply-demand ratio
- Controls ventricular rate in atrial fibrillation and flutter through AV node conduction slowing
- Provides 24-hour hemodynamic control with sustained-release formulations
- Demonstrates proven cardiovascular outcome benefits in long-term clinical studies
- Offers flexible dosing options for individualized therapeutic regimens
Common use
Isoptin is primarily prescribed for the management of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is equally effective in treating chronic stable angina pectoris, particularly in patients with contraindications to beta-blockers. In cardiology practice, it serves as a rate-control agent for supraventricular tachyarrhythmias, especially atrial fibrillation and flutter. Off-label uses include migraine prophylaxis, hypertrophic cardiomyopathy management, and Raynaud’s phenomenon. The selection of immediate versus sustained-release formulation depends on the clinical indication, with sustained-release versions preferred for chronic conditions requiring stable plasma concentrations.
Dosage and direction
For hypertension management, initial dosing typically begins with 80 mg immediate-release tablets three times daily or 180 mg sustained-release once daily, titrated upward at weekly intervals based on therapeutic response. Maximum recommended daily dose is 480 mg for immediate-release and 480 mg for sustained-release formulations. Angina treatment follows similar titration protocols, with most patients achieving optimal effect at 360-480 mg daily divided doses. For arrhythmia management, initial intravenous administration may be utilized in hospital settings followed by oral maintenance therapy. Administration with food may enhance bioavailability while minimizing gastrointestinal discomfort. Dose adjustments are mandatory in hepatic impairment, elderly patients, and those with conduction abnormalities.
Precautions
Regular monitoring of blood pressure, heart rate, and ECG parameters is essential during therapy initiation and dose adjustments. Hepatic function should be assessed periodically due to extensive metabolism, with dose reduction necessary in cirrhosis or severe impairment. Caution is advised in patients with pre-existing conduction defects, sinus node dysfunction, or compromised ventricular function. Gradual withdrawal is recommended to avoid rebound hypertension or angina exacerbation. Patients should be advised about potential dizziness or orthostatic hypotension, particularly during initial therapy or dose escalation. Regular dental care is important due to possible gingival hyperplasia with long-term use.
Contraindications
Absolute contraindications include severe left ventricular dysfunction (ejection fraction <30%), cardiogenic shock, sick sinus syndrome (except with functioning pacemaker), second- or third-degree AV block, atrial flutter or fibrillation with accessory pathways (WPW syndrome), and hypersensitivity to verapamil or related compounds. Concomitant use with ivabradine is prohibited due to additive bradycardic effects. The medication is contraindicated in patients with severe hypotension (systolic <90 mmHg) and should not be administered with strong CYP3A4 inhibitors in those with hepatic impairment.
Possible side effects
Common adverse reactions include constipation (occurring in approximately 7-15% of patients), dizziness (3-10%), nausea (2-7%), hypotension (2-5%), and peripheral edema (1-3%). Less frequent effects include bradycardia, flushing, headache, fatigue, and AV conduction abnormalities. Serious but rare complications include heart failure exacerbation, hepatotoxicity, gingival hyperplasia, and severe dermatological reactions. Most side effects are dose-dependent and often diminish with continued therapy or dose adjustment. Constipation can frequently be managed with dietary modifications or stool softeners without discontinuing therapy.
Drug interaction
Isoptin demonstrates significant interaction potential due to CYP3A4 metabolism and P-glycoprotein inhibition. Concomitant use with beta-blockers may produce additive negative chronotropic and inotropic effects. Co-administration with digoxin increases digoxin serum concentrations by 50-75% requiring dose reduction and monitoring. Simvastatin and lovastatin levels may increase significantly, raising rhabdomyolysis risk. CYP3A4 inhibitors like ketoconazole, clarithromycin, and ritonavir markedly increase verapamil exposure. The drug potentiates effects of neuromuscular blocking agents and may reduce lithium clearance. Grapefruit juice consumption should be avoided due to inhibited metabolism.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never double the dose to make up for a missed administration. For sustained-release formulations, consistency in dosing time is particularly important to maintain stable plasma concentrations. Healthcare providers should be consulted if multiple doses are missed, as temporary blood pressure monitoring may be warranted.
Overdose
Verapamil overdose presents with profound hypotension, bradycardia, conduction abnormalities, and metabolic acidosis. Serum levels exceeding 1000 ng/mL typically produce life-threatening cardiovascular depression. Management includes gastric lavage if presentation is early, activated charcoal administration, and aggressive supportive care. Intravenous calcium gluconate (1-3 g) may temporarily reverse cardiovascular effects. Vasopressors like dopamine or norepinephrine are often required for blood pressure support. Temporary pacing may be necessary for severe bradycardia or heart block. Hemodialysis is ineffective due to high protein binding and extensive distribution.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in original container with tight closure. Protect from moisture, light, and excessive heat. Keep out of reach of children and pets. Do not transfer to alternative containers as this may affect stability. Discard any medication that appears discolored or shows signs of degradation. Proper disposal through medication take-back programs is recommended to prevent environmental contamination or accidental ingestion.
Disclaimer
This information provides educational content about Isoptin but does not replace professional medical advice, diagnosis, or treatment. Always consult qualified healthcare providers regarding medical conditions and before starting or changing any treatment regimen. Individual patient responses may vary, and therapeutic decisions should be based on comprehensive clinical evaluation. The prescribing information provided here may not include all possible uses, directions, precautions, or interactions.
Reviews
Clinical studies demonstrate Isoptin’s efficacy in reducing blood pressure by 12-15 mmHg systolic and 8-10 mmHg diastolic in hypertensive patients. Angina trials show 40-50% reduction in attack frequency and nitrate consumption. In atrial fibrillation, ventricular rate control is achieved in 80-85% of patients within appropriate dose ranges. Long-term outcome data indicate consistent cardiovascular risk reduction with maintained efficacy over years of therapy. Most clinical evaluations note favorable tolerability profile compared to other antihypertensive classes, though individual response variations exist. The sustained-release formulation receives particular praise for improved adherence and stable 24-hour coverage.