Trusted information about Verapamil.

Verapamil: uses Verapamil is used with or without other medications to treat high blood pressure ( hypertension ) . Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Verapamil is called a calcium channel blocker. It works by relaxing blood vessels so blood can flow more easily. Verapamil may also affect heart rate.

Verapamil: how to use Take Verapamil by mouth with or without food, usually once daily at bedtime or as directed by your doctor. Swallow capsules whole. Don't crush or chew capsules. Doing so can destroy long action of drug and may increase side effects.

If we prefer, we may sprinkle the entire contents of a capsule on a small amount of cool, soft applesauce just before taking. Swallow mixture immediately. Do not chew mixture, and don't save the mixture for future use.

Avoid eating grapefruit or drinking grapefruit juice while being treated with Verapamil unless your doctor instructs we otherwise. Grapefruit juice can increase amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.

The dosage is based on your age, medical condition, body size and response to therapy. If we have severe liver problems, your dosage may need to be adjusted.

Use Verapamil regularly in order to get most benefit from it. To help we remember, take it at same time each day. It is important to continue taking Verapamil even if we feel well. Most people with high blood pressure don't feel sick. For the treatment of high blood pressure, it may take up to a week before full benefit of Verapamil takes effect.

Do not suddenly stop taking Verapamil without consulting your doctor. Your condition may become worse when drug is suddenly stopped. Your dose may need to be gradually decreased.

Inform your doctor if your condition worsens ( e. g. , your routine blood pressure readings increase ) .

Verapamil: other used This section contains uses of Verapamil that aren't listed in approved professional labeling for drug but that may be prescribed by your health care professional. Use Verapamil for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Verapamil may also be used to treat chest pain ( angina ) , irregular heartbeat, certain other types of heart disease ( e. g. , hypertrophic cardiomyopathy ) , or for prevention of migraines.

If used for angina, Verapamil must be taken regularly to be effective. It shouldn't be used to treat angina attacks when they occur. Use other medications ( e. g. , sublingual nitroglycerin ) to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details.

Verapamil: side effects Dizziness, nausea, headache, fatigue and constipation may occur as your body adjusts to medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.

To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If we become constipated while using Verapamil, consult your pharmacist for help in selecting a stool softener.

Remember that your doctor has prescribed Verapamil because he or she has judged that benefit to we is greater than risk of side effects. Many people using Verapamil do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Tell your doctor immediately if any of these rare but very serious side effects occur:

A very serious allergic reaction to Verapamil is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

This isn't a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist.

Verapamil: precautions Before taking Verapamil, tell your doctor or pharmacist if we are allergic to it; or to other calcium channel blockers ( e. g. , diltiazem, nifedipine ) ; or if you have any other allergies.

Verapamil should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if we have:

Before using Verapamil, tell your doctor or pharmacist your medical history, especially of:

Verapamil may make you dizzy; use caution engaging in activities requiring alertness such as driving or using machinery.

Verapamil prolongs and intensifies effects of alcohol in your system. Limit alcoholic beverages while using this medication.

Before having surgery, tell your doctor or dentist that we are taking Verapamil.

Verapamil should be used only when clearly needed during pregnancy. Discuss risks and benefits with your doctor.

Verapamil passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding while using Verapamil is not recommended. Consult your doctor before breast-feeding.

Verapamil: interactions See also the How to Use section.

Your healthcare professionals ( e. g. , doctor or pharmacist ) may already be aware of any possible drug interactions and may be monitoring we for it. Do not start, stop or change dosage of any medicine before checking with them first.

Verapamil shouldn't be used with following medications because very serious interactions may occur while use Verapamil:

If we are currently using any of these medications, tell your doctor or pharmacist before starting Verapamil.

Before using Verapamil, tell your doctor or pharmacist of all prescription and nonprescription/herbal products we may use, especially of:

Verapamil also may affect how your body gets rid of some drugs ( e. g. , cyclosporine, sirolimus, tacrolimus, eplerenone, erythromycin, quinidine, midazolam, triazolam, tizanidine, statins including simvastatin, certain anti-seizure drugs including carbamazepine ) .

Check the labels on all your medicines ( e. g. , cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs for pain/fever reduction ) because they may contain ingredients that could increase your blood pressure or heart rate ( e. g. , pseudoephedrine, phenylephrine, chlorpheniramine, diphenhydramine, clemastine, ibuprofen, naproxen ) . Ask your pharmacist about safe use of those products.

This document doesn't contain all possible interactions. Therefore, before using Verapamil, tell your doctor or pharmacist of all the products we use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Verapamil: overdose If overdose of Verapamil is suspected, contact your local poison control center or emergency room immediately. US residents can call US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: severe dizziness/fainting, fast/irregular/very slow heartbeat, confusion.

Verapamil: notes Don't share Verapamil with others. Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

Laboratory and/or medical tests ( e. g. , liver function tests, heart exam, blood pressure, electrocardiograms ) may be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.

There are different brands and types of Verapamil available. Many don't have same effects. Do not change brands or types without consulting your doctor or pharmacist.

Have your blood pressure checked regularly while taking Verapamil. Discuss with your doctor how to monitor your own blood pressure.

Verapamil: missed dose If we miss a dose Verapamil, take it as soon as we remember. If it is near time of the next dose, skip the missed dose and resume your usual dosing schedule. Don't double the dose of Verapamil to catch up.

Verapamil: storage Store Verapamil at room temperature at 77 degrees F ( 25 degrees C ) away from light and moisture. Brief storage between 59-86 degrees F ( 15-30 degrees C ) is permitted. Don't store Verapamil in bathroom. Keep all medicines away from children and pets.

Properly discard Verapamil when it's expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Verapamil with worldwide shipping

Athletes Susceptible To Antibiotic-resistant Staph Infections

Methicillin-resistant Staphylococcus aureus, commonly referred to as MRSA, is a type of staph that causes infections resistant to a class of common antibiotics that includes methicillin, penicillin, amoxicillin and oxacillin. While MRSA infections were traditionally associated with extended hospital stays, they're now becoming more common in everyday life. In fact, this newer form of MRSA known as community-associated MRSA ( CA-MRSA ) can affect otherwise healthy individuals without any recent healthcare-related issues raising fears that the infection can strike anyone, anywhere or anytime.

Now, dermatologists are finding that MRSA infections have become increasingly common among people participating in sports, including high school and college athletes. In report entitled, " Methicillin-resistant Staphylococcus aureus and athletes, " published online in Journal of the American Academy of Dermatology, dermatologist Brian B. Adams, MD, MPH, FAAD, associate professor of dermatology at University of Cincinnati and director of dermatology at Veterans Administration Medical Center, in Cincinnati, addressed the occurrence of MRSA in athletes and recommendations for preventing further spread of the infection.

" Our review found that physical contact, shared facilities and equipment, and poor hygiene all contribute to MRSA among athletes, " said Dr. Adams. " With slight modifications in these areas, individuals participating in contact and non-contact sports can reduce their risk of contracting MRSA. '

Doctor Adams noted that CA-MRSA most frequently appears as an infection of skin and underlying tissues, and looks like a pimple, boil or abscess, sometimes with draining fluid or pus. These lesions may be red, swollen, warm and tender to touch. The most widely reported contact sport linking MRSA infections to athletes is football. In fact, football players experience a variety of factors predisposing them to MRSA infections. These include skin injuries that can occur during play, turf burns from artificial turf that can exacerbate skin trauma, and even an athlete's ingrown toenail can lead to a MRSA infection.

One prominent study conducted during 2003 football season of members of St. Louis Rams professional football team found eight occurrences of MRSA infection among five of 58 Rams players or 9 percent of the team. Dr. Adams pointed out that all of lesions occurred on areas of skin not covered by clothing or equipment where players had suffered turf burns. The players that experienced infections were more likely to have a higher body mass index and play lineman or linebacker position.

" Considering all factors, authors of St. Louis Rams study concluded that frequent antibiotic use, compromised skin barriers, skin contact between players, close proximity of teammates, and inadequate hand and personal hygiene by trainers and athletes may have contributed to team's MRSA outbreak, " said Doctor Adams. " In addition, infections found in players from an opposing team suggested that transmission may have occurred during play. '

Other studies of high school and college football players concluded that shared facilities were likely responsible for MRSA transmission. In each instance, the main risk factor included more than 10 cuts, abrasions or turf burns. One study found that whirlpool use greater than or equal to two times per week increased risk of MRSA infection in players with covered lesions; in another study a member of the high school dance team developed MRSA infection with only link to football team involving use of a shared weight room where dance team changed into their uniforms before football games.

Rugby is another sport that also involves intense physical contact and could potentially expose players to risk factors for contracting MRSA. For example, Doctor Adams explained that limited use of padded equipment in rugby creates potential for more skin-to-skin contact but also reduces risks associated with abrasive, shared or unclean equipment. " One report from United Kingdom found that five members of a rugby team developed large abscesses on upper areas of their arms, back, neck and face, " said Doctor Adams. " Because MRSA infections developed only in forward players, investigators concluded that outbreak probably resulted from sustained physical contact rather than from transmission through shared facilities or equipment. '

In addition, studies show that wrestlers, who often engage in prolonged physical contact and experience frequent mat burns, also may be prone to MRSA infections. In a statewide survey of high school athletic trainers, Texas Department of Health noted six MRSA infections involving wrestlers; another report issued by the Indiana Department of Health identified two high school wrestlers infected with MRSA.

" In this latter study, two affected teammates had never wrestled each other because they competed in different weight classes, " said Doctor Adams. " Therefore, transmission of MRSA may have occurred through use of shared items instead of personal contact although high level of person-to-person contact in wrestling remains a potentially significant means of transmitting the infection. '

Doctor Adams noted that additional studies among athletes point to shared personal items as contributing factors for MRSA transmission. Two separate outbreaks involving college athletes in Pennsylvania and California resulted in multiple football players requiring hospitalization due to MRSA infections. The reporting health departments in each instance recognized sharing of unwashed bath towels, balms and lubricants as possible modes of transmission of infection.

While numerous studies have identified potential risk factors for MRSA infection among athletes, few studies have examined the effect of preventive hygienic practices. In an investigation conducted by University of Southern California over the course of three football seasons from 2002 to 2004, the number of MRSA infections among same college players declined over the three-year period when preventive hygienic measures were implemented. These interventions included covering wounds, using hexachlorophene 3% ( an antibacterial skin cleanser ) , prohibiting multiuse pump lotions or other topical massage products, and educating players and trainers about hygiene and importance of not sharing equipment, towels or other personal items.

" It appears that the primary mode of MRSA transmission involves person-to-person contact, but the significance of this risk factor varies among different sports, " added Doctor Adams. " Even in largely non-contact sports such as soccer, volleyball, cross-country, fencing and weight lifting, outbreaks of MRSA infections have been reported suggesting that shared facilities or shared personal items were likely culprit.

At a minimum, Doctor Adams recommends that all those involved in athletics follow the Centers for Disease Control and Prevention's ( CDC's ) measures for preventing MRSA infections among sports participants, which includes:

-- Cover all wounds. If a wound can't be covered adequately, consider excluding players with potentially infectious skin lesions from practice or competitions until lesions are healed or can be covered adequately.

-- Encourage good hygiene, including showering and washing with soap after all practices and competitions.

-- Ensure availability of adequate soap and hot water.

-- Discourage sharing of towels and personal items, such as clothing or equipment.

-- Establish routine cleaning schedules for shared equipment.

-- Train athletes and coaches in first aid for wounds and recognition of wounds that are potentially infected.

-- Encourage athletes to report skin lesions to coaches and ask coaches to assess athletes regularly for skin lesions.

Doctor Adams recommends seeing a dermatologist if you notice any unusual symptoms that could indicate a skin infection.

Headquartered in Schaumburg, Ill. , the American Academy of Dermatology ( Academy ) , founded in 1938, is largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15, 000 physicians worldwide, the Academy is committed to: advancing diagnosis and medical, surgical and cosmetic treatment of skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails

American Academy of Dermatology ( AAD ) 930 E. Woodfield Rd. Schaumburg, IL 60173-4927 United States http: //www. aad. org

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