verapamil interactions

Verapamil (Oral Route) Side Effects

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Written by BFH Staff Writer on April 17, 2024

Verapamil is a medication primarily used to treat high blood pressure, chest pain (angina), and certain heart rhythm disorders. While it can be highly effective in managing these conditions, like any medication, it comes with potential side effects. Understanding these side effects is crucial for anyone taking verapamil to ensure safe and effective treatment.

What is Verapamil Used For?

Verapamil belongs to a class of drugs known as calcium channel blockers. It works by relaxing blood vessels and improving blood flow, which helps to lower blood pressure and reduce the workload on the heart. Verapamil can also help to regulate heart rhythm by affecting the electrical activity of the heart muscle.

Common Side Effects

Navigating the side effects of verapamil is crucial for those undergoing treatment. Here are some of the common side effects of this medication:

  1. Dizziness or lightheadedness – Verapamil can cause a drop in blood pressure, leading to feelings of dizziness or lightheadedness, especially when standing up quickly. It’s essential to rise slowly from sitting or lying down positions to minimize this effect.
  2. Constipation – Verapamil can slow down bowel movements, resulting in constipation for some individuals. Increasing fiber intake and staying hydrated can help alleviate this symptom.
  3. Flushing or warmth – Some people may experience flushing or warmth in the face or skin while taking verapamil. This side effect is usually mild and temporary.
  4. Headache – Headaches are a common side effect of verapamil, especially when starting the medication or adjusting the dosage. These headaches typically improve over time as the body adjusts to the medication.
  5. Fatigue or tiredness – Verapamil may cause feelings of fatigue or tiredness, particularly during the initial stages of treatment. Getting an adequate amount of rest and maintaining a healthy lifestyle can help manage this side effect.

Less Common But Serious Side Effects

While less common, some individuals may experience more severe side effects while taking verapamil. It’s essential to seek medical attention if you experience any of the following:

  1. Irregular heartbeat – Verapamil is used to regulate heart rhythm, but in some cases, it may cause irregular heartbeats or palpitations. If you notice a rapid or irregular heartbeat, seek medical attention immediately.
  2. Swelling – Verapamil can sometimes cause swelling in the ankles, feet, or hands. This could be a sign of fluid retention or a more severe allergic reaction and should be evaluated by a healthcare professional.
  3. Shortness of breath – Difficulty breathing or shortness of breath can occur as a rare side effect of verapamil. If you experience sudden or severe shortness of breath, seek medical help right away.
  4. Fainting – Verapamil may cause fainting spells, especially if blood pressure drops too low. If you faint or feel faint while taking verapamil, it’s crucial to discuss this with your doctor.

Verapamil Interactions

Verapamil, a common medication for hypertension and heart rhythm disorders, can interact with several drugs and substances, potentially leading to adverse effects. 

Notable interactions include enhanced effects with beta-blockers, increased levels of digoxin, statins, and cyclosporine, as well as interactions with grapefruit juice and certain antibiotics. These interactions can result in toxicity, reduced efficacy, or heightened side effects.

Close monitoring and possible dosage adjustments are often necessary when combining verapamil with other medications. Additionally, patients should always inform their healthcare provider about all medications, supplements, and dietary habits to minimize the risk of adverse interactions and ensure safe treatment.

Verapamil And Alcohol

Combining verapamil with alcohol can potentially increase the risk of side effects and adverse reactions. Both verapamil and alcohol can depress the central nervous system, leading to symptoms such as dizziness, drowsiness, and impaired coordination. Consuming alcohol while taking verapamil may exacerbate these effects, making it dangerous to drive or operate machinery. Additionally, alcohol can affect blood pressure levels, which may interact with the blood pressure-lowering effects of verapamil, potentially causing excessive blood pressure lowering or irregular heart rhythms.

Verapamil Overdose

Verapamil overdose can lead to serious complications and requires immediate medical attention. Symptoms of an overdose may include severe dizziness, fainting, slow or irregular heartbeat, difficulty breathing, confusion, and seizures. It can also result in dangerously low blood pressure, which can lead to shock and organ damage.

Treatment for verapamil overdose typically involves supportive measures to stabilize the individual’s condition, such as intravenous fluids to maintain blood pressure, medications to manage symptoms like irregular heart rhythms, and activated charcoal to help absorb any remaining verapamil in the stomach.

In severe cases, additional interventions such as gastric lavage or hemodialysis may be necessary to remove excess verapamil from the body. 


Verapamil is a valuable medication for managing high blood pressure, chest pain, and certain heart rhythm disorders. While it can be highly effective, it’s essential to be aware of potential side effects. By understanding these side effects and knowing when to seek medical attention, you can ensure safe and effective treatment with verapamil. Always consult your healthcare provider if you have any concerns or experience unusual symptoms while taking this medication.

Frequently Asked Questions (FAQs)

Does Verapamil lower heart rate?

Verapamil is a calcium channel blocker medication that is often used to regulate heart rate in addition to treating high blood pressure and certain heart rhythm disorders. By affecting the electrical activity of the heart muscle, verapamil can help to slow down heart rate and stabilize irregular rhythms. However, individual responses to verapamil may vary, and not everyone will experience a significant decrease in heart rate.

Why take Verapamil at night?

Taking verapamil at night is recommended to control blood pressure during high-risk early morning hours, reduce common side effects like dizziness and fatigue, regulate heart rhythm, and enhance medication adherence. 

Does Amlodipine lower heart rate?

Amlodipine primarily works by relaxing blood vessels to improve blood flow, which helps to lower blood pressure. While it may not directly lower heart rate, some individuals may experience a slight decrease in heart rate as a result of decreased blood pressure. However, amlodipine is not typically prescribed to target heart rate reduction specifically.

Does Amlodipine cause constipation?

Constipation is not a commonly reported side effect of amlodipine. However, like any medication, individual responses can vary. If you experience constipation while taking amlodipine, it’s essential to discuss this with your healthcare provider, as they may recommend adjustments to your treatment plan or suggest strategies to alleviate this symptom.

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