Isoptin Sr

For most conditions, the dose of Isoptin SR (Verapamil) for adults is 80 mg to 120 mg taken 3 or 4 times daily with food. This dose may be increased to a maximum of 480 mg daily. When treating specific conditions where the heart muscle is enlarged and preventing the heart from working efficiently, the dose may be increased to 600 mg or 720 mg of Isoptin SR (Verapamil) divided throughout the day.

If you use the sustained-release (SR) tablets, the recommended dose of Isoptin SR (Verapamil) ranges from 180 mg to 480 mg daily with food. The SR tablets are to be taken once daily if the dose is 240 mg or less. Doses over 240 mg daily of the SR tablets should be taken in 2 divided doses (morning and evening) with food. Do not chew or crush the sustained-release tablets. Do not take more than 480 mg daily.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Isoptin SR (Verapamil) exactly as prescribed by the doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Isoptin SR (Verapamil) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause constipation - to prevent this, drink plenty of water or juice, and eat more dietary fibre; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; in rare cases it may cause your gums to become swollen or sensitive - see your dentist for your scheduled check-ups; it may cause nausea or, rarely, vomiting; it may cause leg swelling or water retention. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

120 mg
Each white, biconvex, round, film-coated tablet with "120 SR" embossed on one side and "KNOLL" on the other contains 120 mg of Isoptin SR (Verapamil) HCl. Nonmedicinal ingredients: hydroxypropyl methylcellulose, macrogol 400, macrogol 6000, magnesium stearate, microcrystalline cellulose, montan glycol wax, povidone, purified water, sodium alginate, talc, and titanium dioxide.

180 mg
Each old rose, oval, film-coated tablet with "KNOLL" on one side and "SR", score, "180" on the other contains 180 mg of Isoptin SR (Verapamil) HCl. Nonmedicinal ingredients: hydroxypropyl methylcellulose, macrogol 400, macrogol 6000, magnesium stearate, microcrystalline cellulose, montan glycol wax, povidone, purified water, red iron oxide, sodium alginate, talc, and titanium dioxide.

240 mg
Each light-green, scored, oblong, film-coated tablet with 2 triangles embossed on one side contains 240 mg of Isoptin SR (Verapamil) HCl. Nonmedicinal ingredients: hydroxypropyl methylcellulose, indigo carmine, macrogol 400, macrogol 6000, magnesium stearate, microcrystalline cellulose, montan glycol wax, povidone, purified water, quinoline yellow, sodium alginate, talc, and titanium dioxide.

Do not use Isoptin SR (Verapamil) if you:

• are allergic to Isoptin SR (Verapamil) or any ingredients of Isoptin SR (Verapamil)
• are suffering from severe Congestive Heart Failure and/or severe left ventricular dysfunction unless it is due to a cause that is treatable by Isoptin SR (Verapamil)
• have a very low heart rate
• have certain types of abnormal heart rhythms, including atrial flutter or atrial fibrillation and an accessory bypass tract (e.g., Wolff-Parkinson-White, Lown-Ganong-Levine syndromes)
• have severe Low Blood Pressure
• have second- or third-degree heart block or sick sinus syndrome

Isoptin SR (Verapamil) should not be given to people who are in cardiogenic shock or those who are suffering from certain types of complicated Heart Attack.

There may be an interaction between Isoptin SR (Verapamil) and any of the following:

• Afatinib
• alcohol
• Aliskiren
• alpha agonists (e.g., Clonidine, methyldopa)
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• Almotriptan
• amphetamines (e.g., Dextroamphetamine, lisdexamphetamine)
• Amiodarone
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., candasartan, Irbesartan, Losartan)
• anti-cancer medications (e.g., Cabazitaxel, Docetaxel; Doxorubicin; Etoposide, Ifosfamide, Irinotecan, Vincristine)
• Apixaban
• Aprepitant
• "azole" antifungals (e.g., ketoconazole, fluconazole)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Diazepam, Lorazepam)
• beta-blockers (e.g., Propranolol, Metoprolol)
• boceprevir
• Bosentan
• brimonidine
• Bromocriptine
• Buspirone
• Calcitriol
• Carbamazepine
• other calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine)
• calcium salts (e.g., calcium carbonate, calcium gluconate)
• certain medications that affect your immune system (e.g., Cyclosporine, Sirolimus, Tacrolimus, Everolimus)
• chloroquine
• ciprofloxacin
• Clopidogrel
• Cimetidine
• clopidogrel
• Colchicine
• conivaptan
• corticosteroids (e.g., budesonide, Dexamethasone, fluticasone, Hydrocortisone, Prednisone)
• cyclosporine
• dabigatran
• Dantrolene
• Dapsone
• Deferasirox
• Digoxin
• dofetilide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Domperidone
• Dronedarone
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• everolimus
• felbamate
• Fentanyl
• Fingolimod
• "gliptin" Diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
• Glyburide
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Hydralazine
• levodopa
• lithium
• Loperamide
• losartan
• macrolide antibiotics (e.g., clarithromycin, erythromycin, telithromycin)
• magnesium supplements
• maraviroc
• Mefloquine
• mestranol
• Metformin
• Methadone
• Methylphenidate
• Metronidazole
• Mirtazapine
• Modafinil
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Montelukast
• Morphine
• neuromuscular blocking agents (e.g., atracurium, pancuronium)
• non-steroidal anti-inflammatory medications (NSAIDS; e.g., Ibuprofen, Naproxen)
• Norfloxacin
• other medications that treat abnormal heart rhythms (e.g., Disopyramide, Flecainide, Propafenone, quinidine)
• nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate)
• Ondansetron
• Oxcarbazepine
• Oxycodone
• Phenytoin
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pimozide
• primidone
• progestins (e.g., Dienogest, Levonorgestrel, medroxyprogesterone, Norethindrone)
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• Ranitidine
• Repaglinide
• rifabutin
• Risperidone
• rifampin
• Rituximab
• Rivaroxaban
• Romidepsin
• St. John's wort
• salmeterol
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Duloxetine, Fluoxetine, Paroxetine, Sertraline)
• simeprevir
• "statin" medications (e.g., Atorvastatin, Lovastatin, Simvastatin)
• Sulfinpyrazone
• tacrolimus
• Tamoxifen
• telaprevir
• Tetracycline
• Theophylline
• Tolvaptan
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine, Imipramine)
• Trimethoprim
• tyrosine kinase inhibitors (e.g., Bosutinib, Dasatinib, imatinib)
• Venlafaxine
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Isoptin SR (Verapamil). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Isoptin SR (Verapamil).

Heart failure: Isoptin SR (Verapamil) works partially by reducing the force of the heart’s contractions which can cause the symptoms of heart failure to become worse. If you have heart failure that is not well-corrected, discuss with your doctor how Isoptin SR (Verapamil) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: Kidney Disease or reduced kidney function may cause Isoptin SR (Verapamil) to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Isoptin SR (Verapamil) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Isoptin SR (Verapamil), and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Isoptin SR (Verapamil) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Isoptin SR (Verapamil) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Isoptin SR (Verapamil), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Isoptin SR (Verapamil).

Isoptin SR (Verapamil) may also reduce liver function and can cause liver failure. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure and heart rate: Low blood pressure symptoms of tiredness and weakness with faintness have been reported following single doses and even after some months of treatment with Isoptin SR (Verapamil). Some people may require a reduced dose. Isoptin SR (Verapamil) can cause very low heart rate for some people. Report an abnormally low heart rate (less than 50 beats per minute) or persistent fatigue to your doctor.

Neuromuscular disease: If you have a neuromuscular disease such as Myasthenia Gravis, Lambert-Eaton syndrome, or Duchenne's muscular dystrophy, discuss with your doctor how Isoptin SR (Verapamil) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: Isoptin SR (Verapamil) reaches the developing baby if it is taken during pregnancy. Isoptin SR (Verapamil) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Isoptin SR (Verapamil), contact your doctor immediately.

Breast-feeding: Isoptin SR (Verapamil) passes into breast milk. If you are a breast-feeding mother and are taking Isoptin SR (Verapamil), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Isoptin SR (Verapamil) have not been established for children.

Seniors: Seniors may have a higher risk of side effects with Isoptin SR (Verapamil). Your doctor may recommend lower doses to reduce this risk.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. This medication should be swallowed whole. It should not be split, crushed or chewed. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication is more effective if taken with food. Always take it with a meal or a snack. Avoid grapefruit and grapefruit juice during your treatment. Grapefruit can seriously affect how this medication works. If you drink alcohol, a moderate consumption is recommended. Talk to your health care professional to find out exactly how much alcohol you can drink.