verapamil

Adult Dosing .

Dosage forms:  ER CAP (24h, AM): 120 mg, 180 mg, 240 mg, 360 mg; ER CAP (24h, PM): 100 mg, 200 mg, 300 mg; TAB: 40 mg, 80 mg, 120 mg; ER TAB (12h): 120 mg, 180 mg, 240 mg; INJ: various

angina

[80-120 mg PO tid]

Max: 480 mg/day; Info: start 40 mg PO tid in elderly or small stature pts; may incr. dose daily in unstable angina pts, otherwise may incr. qwk

HTN

[immediate-release form]

Dose: 80-120 mg PO tid; Start: 80 mg PO tid; Max: 480 mg/day; Info: start 40 mg PO tid in elderly or small stature pts

[12h extended-release form]

Dose: 180-480 mg/day ER PO divided qd-bid; Start: 180 mg ER PO qam; Max: 480 mg/day ER; Info: start 120 mg ER PO qam in elderly or small stature pts; divide dose bid if >240 mg/day ER; give w/ food; do not cut/crush/chew ER tab

[24h AM extended-release form]

Dose: 180-480 mg ER PO qam; Start: 240 mg ER PO qam; Max: 480 mg/day ER; Info: start 120 mg ER PO qam in elderly or small stature pts; may open ER cap, but do not crush/chew/dissolve contents

[24h PM extended-release form]

Dose: 200-400 mg ER PO qhs; Start: 200 mg ER PO qhs; Max: 400 mg/day ER; Info: start 100 mg ER PO qhs in elderly or small stature pts; may open ER cap, but do not crush/chew/dissolve contents

PSVT conversion

[2.5-5 mg IV x1, then 5-10 mg IV q15-30min prn]

Max: 20 mg/total dose; Alt: 5 mg IV q15min up to 30 mg/total dose

PSVT prevention

[80-120 mg PO tid-qid]

Max: 480 mg/day

atrial fibrillation/flutter

[immediate rate control]

Dose: 5-20 mg/h IV; Start: 5-10 mg IV x1, may repeat x1-2 doses after 30min if inadequate response, then 5-20 mg/h IV; Max: 20 mg/h

[maintenance rate control, immediate-release form]

Dose: 180-480 mg/day PO divided tid-qid; Start: 120 mg/day PO divided tid-qid; Max: 480 mg/day

[maintenance rate control, 12h or 24h AM extended-release form (off-label)]

Dose: 180-480 mg/day ER PO divided qd-bid; Start: 120 mg ER PO qd; Max: 480 mg/day; Info: give ER tab w/ food; do not cut/crush/chew ER tab; may open ER cap, but do not crush/chew/dissolve contents

migraine prophylaxis (off-label)

[80 mg PO tid]

Info: adjust dose based on response

cluster headache prophylaxis (off-label)

[240-480 mg/day PO divided tid-qid]

Start: 40-80 mg PO tid, may incr. dose by 80 mg/day q3-4 days; Info: taper dose gradually over 2-4wk to D/C

renal dosing

[see below]

renal impairment: not defined, caution advised

HD/PD: not defined

hepatic dosing

[see below]

hepatic impairment: decr. usual dose by 70%; Info: consider alternate dosage form instead of ER

Peds Dosing .

Dosage forms:  TAB: 40 mg, 80 mg, 120 mg; INJ: various

PSVT conversion

[<1 yo]

Dose: 0.1-0.2 mg/kg/dose IV x1; Info: may repeat x1 in 30min; not generally recommended in children <2 yo

[1-15 yo]

Dose: 0.1-0.3 mg/kg/dose IV x1; Max: 5 mg/first dose; Info: may give second dose up to 10 mg in 30min; not generally recommended in children <2 yo

HTN (off-label)

[4-8 mg/kg/day PO divided tid]

Max: 480 mg/day

renal dosing

[see below]

renal impairment: not defined, caution advised; Info: consider decr. usual dose if CrCl <10

HD/PD: not defined

hepatic dosing

[adjust dose amount]

hepatic impairment: decr. usual dose by 70%