Common questions about verapamil - Brand names: Securon, Verapress, Vera-Til

Verapamil is a type of medicine called a calcium channel blocker.

If you have angina, verapamil works by widening your arteries, making it easier for blood to flow to your heart. This prevents the chest pain that comes on when not enough blood gets to the muscles of the heart.

If you have high blood pressure, verapamil works by stopping calcium going into the muscles in your heart and blood vessels.

Muscles need calcium to contract, so when you stop the calcium, it makes the muscles relax. This lowers your blood pressure and makes it easier for your heart to pump blood around your body.

If you have an irregular heart rhythm, verapamil works by slowing down your heart rate as well as improving the blood supply to your heart.

Verapamil starts to work on the day you start taking it, but it may take a couple of weeks to work fully.

If you're taking it for angina, you may still get some chest pain until verapamil starts working fully. Make sure you have your medicine (spray or tablets) for treating angina attacks with you all the time and use it if you need to.

Talk to your doctor if your chest pain does not get any better after a couple of weeks. If it gets worse, tell your doctor straight away.

If you're taking verapamil for high blood pressure or an irregular heart rhythm you may not have had any symptoms.

If this is the case, you may not feel any different when you take it. However the medicine is still working and it's important to keep taking it. Your doctor will check to see how well it's working.

There are other calcium channel blockers that can help with angina symptoms, such as:

• amlodipine
• diltiazem
• nifedipine

There are also other medicines that help to prevent angina attacks. They include:

• beta blockers such as bisoprolol
• nitrates such as isosorbide mononitrate
• medicines such as ranolazine, nicorandil or ivabradine

These medicines work in different ways so it's difficult to say whether one is better than the other.

If verapamil does not work for you, you may be able to switch to another medicine. Your doctor will be able to decide which medicine is best for you. Some people may need to take a combination of medicines to control their angina symptoms.

There are several other calcium channel blockers that can be used for high blood pressure such as:

• amlodipine
• diltiazem
• felodipine
• nifedipine

There are also lots of other types of medicines to lower your blood pressure. They work in a different way to calcium channel blockers and include:

• ACE inhibitors such as ramipril and lisinopril
• angiotensin receptor blockers such as candesartan
• beta blockers such as bisoprolol
• diuretics such as bendroflumethiazide

If you cannot take verapamil or other calcium channel blockers because of side effects, you may be able to switch to another medicine.

Your doctor will advise which one is best for you depending on your age, ethnicity and medical history. Many people need take more than 1 medicine for high blood pressure.

Diltiazem is another calcium channel blocker that can be used for irregular heart rhythms (arrhythmias).

Some other medicines which are used for arrhythmias and help control heart rate include:

• beta blockers such as bisoprolol or atenolol
• digoxin
• flecainide
• amiodarone

These medicines all work differently and side effects can vary. Your doctor will be able to recommend the best medicine for your particular type of arrhythmia.

You may need to try a few different medicines before you find a combination that controls your symptoms but does not cause side effects.

Verapamil does not stop any type of contraception from working, including emergency contraception.

However, some hormonal methods of contraception, such as the combined pill and contraceptive patch, are not usually recommended if you have high blood pressure.

Talk to your doctor if you're taking combined hormonal contraceptives.

If verapamil makes you sick (vomit), your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Verapamil can make some people feel dizzy. If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel better.

Alcohol can increase the effects of verapamil. This means that you may not have to drink as much to be above the legal limit to drive and it will take longer for the alcohol to leave your body.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking verapamil.

GOV.UK has more information on the law on drugs and driving

Alcohol can increase the effects of verapamil. Also, verapamil can affect the way the body gets rid of alcohol, and increase the levels of alcohol in the body. This means that you may not have to drink as much to be above the legal limit to drive and it will take longer for the alcohol to leave your body.

It can also make your blood pressure too low and you may feel dizzy or lightheaded.

It's best to not drink alcohol for the first few days when you start taking verapamil or if your doctor increases your dose. Wait until you know how the medicine affects you.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Do not eat grapefruit or drink grapefruit juice while taking verapamil. This is because grapefruit can increase the levels of verapamil in the body and make the side effects of verapamil worse.

Otherwise, you can eat and drink normally while taking verapamil.

Eating a healthy balanced diet can help if you have high blood pressure.

You can boost the health of your heart by making some key lifestyle changes. These will also help if you have high blood pressure or angina.

• Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic. Walking every day will help.
• Eat well – try to include plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins in your diet.
• Reduce salt in your diet – eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Deal with stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help reduce stress.
• Vaccinations – it's recommended that you have the flu vaccine every year and the pneumococcal vaccine and COVID-19 vaccine as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS.