In addition to verapamil hci, the isoptin sr tablet contains the following ingredients alginate, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl pyrrolidone, talc, and titanium dioxide.

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Urogenitalgynecomastiaimpotencegalactorrhea/hyperprolactinemiaincreased urinationspotty menstruation.

CimetidineThe interaction between cimetidine and chronically administered verapamil has not been studiedVariable results on clearance have been obtained in acute studies of healthy volunteersclearance of verapamil was either reduced or unchanged.

Neuromuscular Blocking AgentsClinical data and animal studies suggest that verapamil may potentiate the activity of neuromuscular blocking agentscurare-like and depolarizingIt may be necessary to decrease the dose of verapamil and/or the dose of the neuromuscular blocking agent when the drugs are used concomitantly.

If you miss a dosetake it as soon as you rememberIf it is near the time of the next doseskip themissed doseTake your next dose at the regular timeDo not double the dose to catch up.

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Accessory Bypass TractWolff-Parkinson-White or Lown-Ganong-LevineSome patients with paroxysmal and/or chronic atrial fibrillation or atrial flutter and a coexisting accessory AV pathway have developed increased antegrade conduction across the accessory pathway bypassing the AV nodeproducing a very rapid ventricular response or ventricular fibrillation after receiving intravenous verapamilor digitalisAlthough a risk of this occurring with oral verapamil has not been establishedsuch patients receiving oral verapamil may be at risk and its use in these patients is contraindicatedsee CONTRAINDICATIONS

Accessory Bypass TractWolff-Parkinson-White or Lown-Ganong-LevineSome patients with paroxysmal and/or chronic atrial fibrillation or atrial flutter and a coexisting accessory AV pathway have developed increased antegrade conduction across the accessory pathway bypassing the AV nodeproducing a very rapid ventricular response or ventricular fibrillation after receiving intravenous verapamilor digitalisAlthough a risk of this occurring with oral verapamil has not been establishedsuch patients receiving oral verapamil may be at risk and its use in these patients is contraindicatedsee CONTRAINDICATIONS

This is not a complete list of possible side effectsIf you notice other effects not listed abovecontact your doctor or pharmacist.

Some side effects of verapamil may occur that usually do not need medical attentionThese side effects may go away during treatment as your body adjusts to the medicineAlsoyour health care professional may be able to tell you about ways to prevent or reduce some of these side effectsCheck with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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Serious adverse reactions are uncommon when verapamil therapy is initiated with upward dose titration within the recommended single and total daily doseSee WARNINGS for discussion of heart failurehypotensionelevated liver enzymesAV blockand rapid ventricular responseReversibleupon discontinuation of verapamilnon-obstructiveparalytic ileus has been infrequently reported in association with the use of verapamilThe following reactions to orally administered verapamil occurred at rates greater than 1.0or occurred at lower rates but appeared clearly drug-related in clinical trials in 4,954 patients.

Older adults may be more sensitive to the side effects of this drugespecially constipationor swelling ankles/feet.

CarbamazepineVerapamil may increase carbamazepine concentrations during combined therapyThis may produce carbamazepine side effects such as diplopiaheadacheataxiaor dizziness.

Some products have ingredients that could raise your heart rate or blood pressureTell your pharmacist what products you are usingand ask how to use them safelyespecially cough-and-cold productsdiet aidsor NSAIDs such as ibuprofen/naproxen

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