Take verapamil exactly as your doctor has told you and follow the instructions that come with your medicine. If you're not sure, ask a pharmacist or your doctor.
Dosage and strength
The dose of verapamil depends on why you're taking it.
If you have liver disease, your doctor may prescribe you a low dose and will monitor you more closely.
If a doctor has prescribed verapamil for your child, the dose will usually be lower than adults. It will depend on how old your child is. Children will usually be given standard tablets or liquid.
Liquid verapamil contains 40mg in each 5ml spoonful.
Dose for high blood pressure
If you're taking standard tablets or liquid, the usual dose is 120mg, taken twice a day. Your doctor may increase your dose to a maximum of 480mg a day, split into 2 or 3 doses.
If you're taking slow-release tablets, the usual dose is 240mg, taken once a day. Your doctor may increase it to 480mg a day. If your dose is higher than 240mg daily, it can be split into 2 doses and taken morning and evening.
Dose for angina
If you're taking standard tablets or liquid, the usual dose is 80mg or 120mg, taken 3 times a day. Some people may find that taking verapamil twice a day is enough to control their symptoms.
If you're taking slow-release tablets, the usual dose is 240mg, taken twice a day. Your doctor might reduce this dose to 240mg taken once a day.
Dose for irregular heart rhythm
For irregular heart rhythm, you'll be given standard tablets or liquid. The usual dose is between 40mg and 120mg, taken 3 times a day.
Dose after a heart attack
After a heart attack, you'll be given slow-release tablets. The usual dose is 360mg a day, split into 2 or 3 doses throughout the day. This can be taken as 240mg in the morning and 120mg in the evening, or as 120mg taken 3 times a day.
You'll usually wait at least 1 week after a heart attack before starting verapamil.
Changes to your dose
Sometimes the dose you start on does not work well enough and your blood pressure does not lower enough, or your angina is not controlled. If this happens, your doctor will gradually increase your dose.
Your doctor may also lower your dose if your blood pressure is controlled or the side effects bother you.
How to take verapamil
Verapamil comes as standard tablets, slow-release (long-acting) tablets, and a liquid (oral solution).
Slow-release tablets release the medicine gradually into your body. This means you do not need to take them as often.
Swallow your tablets whole with a drink of water. Do not chew or crush them, as it's important that they go into your stomach before they dissolve.
You can take verapamil at any time of day, but try to take it around the same time every day.
If you're taking verapamil as a liquid, it will come with a plastic syringe or spoon to help you take the right amount. If you do not get one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give you the right amount.
You can take verapamil with or without food.
It's important not to eat grapefruit or drink grapefruit juice while you're taking this medicine. Grapefruit can increase the amount of verapamil in your body and make side effects worse.
How long to take it for
Usually, treatment with verapamil is long term, and can be for the rest of your life.
If you forget to take it
If you forget to take a dose of verapamil, take it as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take your next dose at the usual time.
Do not take 2 doses at the same time to make up for a missed dose. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
Taking too much verapamil can cause your blood pressure to go too low. It can also make you feel faint, dizzy or sleepy because it can cause your heart to beat irregularly.
Urgent advice: Contact 111 for advice now if:
- you take more than your prescribed dose of verapamil
Call 111 or get help from 111 online.
If you need advice for a child under the age of 5 years, call 111.
If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.
Bring the verapamil packet or leaflet inside it, any remaining medicine, and any other medicines you take.
Stopping verapamil
Talk to your doctor if you want to stop taking verapamil.
Stopping verapamil may cause your blood pressure to rise and this may increase your risk of a heart attack or stroke.
If you're bothered by side effects, talk to your doctor. They may be able to prescribe a different medicine for you.