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This safety information outlines crucial warnings and contraindications for the use of Verapamil ER (Verelan). It is essential to understand these risks and consult with your healthcare provider if you have any concerns.

• Heart Failure: Verapamil ER (Verelan) may lead to heart failure and fluid accumulation in the lungs, particularly if you have a history of heart disease. Symptoms to watch for include shortness of breath, fatigue, swelling in the feet, legs, or stomach, rapid weight gain, dizziness, and coughing. Discuss with your healthcare provider if you have a history of heart-related issues, as additional medications like diuretics might be necessary.

• Low Blood Pressure: This medication can cause significant drops in blood pressure, though it is uncommon in those with high blood pressure. Be vigilant for symptoms such as dizziness, lightheadedness, weakness, blurred vision, dehydration, sweating, cold or pale skin, rapid breathing, or confusion. Inform your healthcare provider if you have a history of low blood pressure or are taking other blood pressure medications.

• Liver Concerns: Verapamil ER (Verelan) might elevate liver protein levels, some of which may be harmless, while others could indicate serious liver issues. Notify your healthcare provider if you have liver disease, as regular blood tests may be required. Watch for symptoms like jaundice, abdominal pain or swelling, appetite loss, dark urine, nausea, vomiting, fatigue, or confusion, and report them immediately as they could signify liver damage.

• Heart Rhythm Disturbances: The drug may alter heart rhythms, potentially causing a temporary decrease in heart rate or, rarely, a life-threatening condition known as heart block (AV block). Emergency medical attention is necessary if you experience chest pain, dizziness, shortness of breath, extreme fatigue, fainting, or palpitations. This risk increases if you are on other blood pressure medications, particularly beta-blockers.

• Specific Heart Conditions: It is vital to inform your healthcare provider of any heart-related medical history, especially conditions like Wolff-Parkinson-White syndrome, Lown-Ganong-Levine syndrome, or hypertrophic cardiomyopathy, as these can complicate treatment with Verapamil ER (Verelan).

Contraindications:

• Verapamil ER (Verelan) should not be used if you have certain heart conditions, such as left ventricular dysfunction, very low blood pressure (systolic pressure under 90 mmHg), or cardiogenic shock.
• Avoid this medication if you have sick sinus syndrome, a 2nd- or 3rd-degree heart block, or irregular heart rhythms like atrial fibrillation or atrial flutter with additional heart muscle tissue (Wolff-Parkinson-White or Lown-Ganong-Levine syndrome).

Consult your healthcare provider for personalized advice and to ensure the safe use of Verapamil ER (Verelan).

When taking this medication, some individuals may experience common side effects that are usually mild and manageable. These include dizziness, constipation, nausea, headache, tiredness, and stomach upset. To help prevent dizziness and lightheadedness, rise slowly from sitting or lying positions. It's important to remember that while these side effects can occur, many people use this medication without experiencing serious issues.

However, there are more serious side effects that require immediate medical attention if they occur. These include severe dizziness, fainting, symptoms of heart failure such as shortness of breath, swelling of the ankles or feet, unusual tiredness, and significant weight gain. The medication has also been rarely associated with potentially fatal liver disease. Symptoms to watch for include persistent nausea or vomiting, loss of appetite, stomach or abdominal pain, yellowing of the eyes or skin, and dark urine.

While allergic reactions to this medication are rare, they can be serious. If you experience symptoms such as a rash, itching or swelling, especially of the face, tongue, or throat, severe dizziness, or trouble breathing, seek medical assistance immediately. If you notice any other side effects, whether listed here or not, it is advisable to consult your healthcare provider for guidance.

Verapamil ER (Verelan) can interact with several other medications and products. It's crucial to inform your healthcare provider about all the medicines and supplements you are currently taking, including prescription, over-the-counter, vitamins, and herbal products. Here’s a breakdown of potential interactions:

1. Drugs to Avoid: It's generally advised not to use Verapamil with certain medications due to significant interactions. These include colchicine, dofetilide, eliglustat, flibanserin, and lomitapide. Your doctor might choose alternative treatments if you are taking any of these.

2. Cautionary Use: Some medications should be used with caution when combined with Verapamil. These include drugs like clonidine, erythromycin, and labetalol. If both medications are necessary, your healthcare provider may adjust the dosage or frequency to minimize interaction risks.

3. Altered Drug Efficacy: Verapamil may impact how other medications are processed in your body, potentially altering their effectiveness. Examples include colchicine, midazolam, and ivabradine. Your doctor might need to adjust your treatment plan accordingly.

4. Risk of Increased Side Effects: Combining Verapamil with certain drugs can increase side effects. These include apixaban, cyclosporine, and lithium. In these cases, your healthcare provider may closely monitor your treatment or modify your medication regimen.

Additionally, some over-the-counter products, such as certain cough-and-cold remedies, diet aids, or NSAIDs like ibuprofen and naproxen, may affect your heart rate or blood pressure. Consult your pharmacist or doctor about using these products safely. Always communicate openly with your healthcare team to ensure safe and effective use of Verapamil.