Verapamil Hydrochloride ER
Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• Excess calcium and vitamin D may interfere with the action of Verapamil. Discuss proper levels with your physician or pharmacist.1
• Alcohol use should be limited.2
• Limit caffeine intake, including sodas, coffee, tea, chocolate, and nutritional supplements containing caffeine.3
• Grapefruit and grapefruit juice may interact with Verapamil if used long term. A single dose of grapefruit juice does not seem to affect the drug.4
• Avoid natural Licorice products, ginseng, and ephedra (ma huang) which may interfere with verapamil.5
• The following herbs may have diuretic properties, which may increase the effects of Verapamil and may possibly lead to an excessive lowering of blood pressure: Alfalfa, Angelica, Astragalus, Basil, Bean Pod, Buckthorn, Burdock, Butcher’s Broom, Buchu, Celery, Cleavers, Cornflower, Dandelion, Elecampane, Elder, Goat's Rue, Hempnettle, Horsetail, Indian-Hemp, Juniper, Marigold, Meadowsweet, Parsley, Rauwolfia, Sarsaparilla, Sweet clover, Turmeric, and Vervain.6
• Avoid cola, cocoa, green tea, guarana and mate with verapamil due to their caffeine content.7
• St. John’s Wort may interact with some calcium channel blockers due to the use of similar pathways (eg. cytochrome P450) to metabolize the drugs and herb.8
• These herbs have cardiac properties which may increase cardiac side effects of Verapamil: black hellebore, calamus, cereus, cola, coltsfoot, devil's claw, European mistletoe, fenugreek, fumitory, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, pleurisy root, squill bulb leaf scales, white horehound, mate, scotch broom flower, shepherd's purse, and wild carrot9
References1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 274-75.
4 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Fuhr U, Drug interactions with grapefruit juice. Extent, probable mechanism and clinical relevance. Drug Saf 1998 Apr; 18(4): 251-72.
4 Zaidenstien R, Dishi V, Gips M, Soback S, Cohen N, et al, The effect of grapefruit juice on the pharmacokinetics of orally administered verapamil. Eur J Clin Pharmacol 1998 Jun; 54(4): 337-40
5 Pronsky, ZM: Food-Medication Interactions, 11th edition, 1999
5 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
6 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
6 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
7 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
8 Yue QY, Bergquist C, GerdÈn B. Safety of St John's wort (Hypericum perforatum). Lancet 2000;355(9203).
9 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
9 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.