Patients With Hypertrophic Cardiomyopathy (IHSS)
In 120 patients with hypertrophic cardiomyopathy (most of them refractory or intolerant to propranolol) who received therapy with Veracal at doses up to 720 mg/day, a variety of serious adverse effects were seen. Three patients died in pulmonary edema; all had severe left ventricular outflow obstruction and a past history of left ventricular dysfunction. Eight other patients had pulmonary edema and/or severe hypotension; abnormally high (greater than 20 mm Hg) pulmonary wedge pressure and a marked left ventricular outflow obstruction were present in most of these patients. Concomitant administration of quinidine (see DRUG INTERACTIONS) preceded the severe hypotension in 3 of the 8 patients (2 of whom developed pulmonary edema). Sinus bradycardia occurred in 11% of the patients, second-degree AV block in 4%, and sinus arrest in 2%. It must be appreciated that this group of patients had a serious disease with a high mortality rate. Most adverse effects responded well to dose reduction, and only rarely did Veracal use have to be discontinued.
Veracal reduces afterload and myocardial contractility. In most patients, including those with organic cardiac disease, the negative inotropic action of Veracal is countered by reduction of afterload and cardiac index remains unchanged. During isometric or dynamic exercise, Veracal does not alter systolic cardiac function in patients with normal ventricular function. Improved left ventricular diastolic function in patients with Idiopathic Hypertrophic Subaortic Stenosis (IHSS) and those with coronary heart disease has also been observed with Veracal. In patients with severe left ventricular dysfunction (e.g., pulmonary wedge pressure above 20 mm Hg or ejection fraction less than 30%), or in patients taking beta-adrenergic blocking agents or other cardiodepressant drugs, deterioration of ventricular function may occur (see DRUG INTERACTIONS).
In emergency cardiac care, Veracal is used primarily to treat PSVT that does not require cardioversion. When Veracal proves ineffective in the management of PSVT, synchronized cardioversion is recommended.
- Heart problems warning: Avo >
Veracal oral capsule is a prescription medication that’s available as the brand-name drugs Verelan PM (extended-release) and Verelan (delayed-release). The extended-release oral capsule is also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand.
Veracal is also available as an extended-release oral tablet (Calan SR) and an immediate-release oral tablet (Calan). Both forms of these tablets are also available as generic drugs.
Most common side effects
The most common side effects that occur with Veracal include:
- face flushing
- nausea and vomiting
- sexual problems, such as erectile dysfunction
- weakness or tiredness
Veracal can cause a severe allergic reaction. Symptoms may include:
- trouble breathing
- swelling of your throat or tongue
- rash or itching
- swollen or peeling skin
- chest tightness
- swelling of your mouth, face, or lips
Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.
Q: Can I eat or drink grapefruit while on Veracal?
A: Grapefruit, grapefruit juice and certain types of oranges can inhibit the metabolism (breakdown) of certain medications, such as Veracal. When the metabolism is inhibited this can cause higher levels of the medication in the body and potentially dangerous side effects. You may want to discuss the use of grapefruit with your doctor while being treated with Veracal. For additional information regarding Veracal, you may want to visit our website. //www.everydayhealth.com/drugs/Veracal Beth Isaac, PharmD
Treatment Of Acute Cardiovascular Adverse Reactions
The frequency of cardiovascular adverse reactions that require therapy is rare; hence, experience with their treatment is limited. Whenever severe hypotension or complete AV block occurs following oral administration of Veracal, the appropriate emergency measures should be applied immediately; e.g., intravenously administered norepinephrine bitartrate, atropine sulfate, isoproterenol HCl (all in usual doses), or calcium gluconate (10% solution). In patients with hypertrophic cardiomyopathy (IHSS), alpha-adrenergic agents (phenylephrine HCl, metaraminol bitartrate, or methoxamine HCl) should be used to maintain blood pressure, and isoproterenol and norepinephrine should be avoided. If further support is necessary, dopamine HCl or dobutamine HCl may be administered. Actual treatment and dosage should depend on the severity of the clinical situation and the judgement and experience of the treating physician.
Elevated Liver Enzymes
Elevations of transaminases with and without concomitant elevations in alkaline phosphatase and bilirubin have been reported. Such elevations have sometimes been transient and may disappear even in the face of continued Veracal treatment. Several cases of hepatocellular injury related to Veracal have been proven by rechallenge; half of these had clinical symptoms (malaise, fever, and/or right upper quadrant pain) in addition to elevation of SGOT, SGPT, and alkaline phosphatase. Periodic monitoring of liver function in patients receiving Veracal is therefore prudent.
If you suspect an overdose, contact a poison control center or emergency room immediately.
You can get in touch with a poison control center at (800) 222-1222.