Non-dihydropyridine CCB
Verapamil hydrochloride
Brand names: Securon, Cordilox
Adult dose
Dose: PO IR: 40–120mg TDS. PO MR: 240mg OD-BD. SVT IV: 5mg over 2 min, may repeat after 5-10 min
Route: PO/IV
Frequency: OD-TDS
Clinical pearls
- SVT, AF rate control, hypertension, angina
- Avoid in HFrEF; constipation common
Contraindications
- HF (LVEF reduced)
- 2nd/3rd-degree AV block
- Concurrent IV β-blocker
- Severe hypotension
- Atrial fibrillation with WPW
- Cardiogenic shock
Side effects
- Constipation
- Bradycardia
- Heart block
- HF exacerbation
- Hypotension
- Gingival hyperplasia
Interactions
- β-blockers (severe — avoid IV combination)
- Digoxin (raises levels)
- Statins
- Strong CYP3A4 modulators
Monitoring
- BP
- HR
- ECG
Reference: BNF; NICE NG196; ESC; https://bnf.nice.org.uk/drugs/verapamil-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines