Cardiovascular – Renal Drugs : Antiarrhythmics
IVERP1 “Verpamil injection” 2.5 mg/ml; 2 ml/amp
OCINT1 “Cintsu SR FC tablet” 240 mg/tab
OISOP1 “Isoptin tablet” 40 mg/tab
OISOP2 “Isoptin SR FC tablets” 240 mg/tab
適應症：
IVERP1：陣發性上室性心搏過速、對於心房撲動、心房纖維顫動情況時、快速心室心搏之暫時性控制。
OCINT1, OISOP2：高血壓。
OISOP1：狹心症。
Usual dose:
Atrial arrhythmia: IV
Adult: initial, 5-10 mg (0.075-0.15 mg/kg) IV over 2 min; may give additional 10 mg after 30 min if no response.
Pediatric:
(< 1 yr): 0.1-0.2 mg/kg IV over 2 min, may repeat dose after 30 min.
(1-15 yrs): 0.1-0.3 mg/kg IV over 2 min, max. 5 mg, may repeat dose after 30 min, max. 10 mg.
Atrial arrhythmia: PO
Adult: initial, 240-320 mg tid-qid; non-digitalized p’ts may require up to 480 mg tid-qid.
Pediatric: (< 1 yr) 0.1-0.2 mg/kg IV over 2 min, may repeat dose after 30 min.
Angina: PO
Adult: (extended-release) initial, 180 mg q1h; titrate to 480 mg q1h; max. 540 mg q1h; (immediate release) 80-120 mg tid.
Variant angina: PO
Adult: (immediate-release) 80-120 mg tid.
Hypertension: PO
Adult: (extended-release) initial, 180 mg qd hs; maintenance, titrate up to 480 mg qd hs. (immediate-release) initial, 80 mg tid; may titrate at daily or weekly intervals to 360-480 mg/day; (sustained-release) initial, 180 mg qam, maintenance (based on response), may titrate up to 240 mg bid or 480 mg qam.
Pediatric: 3-4 mg/kg in 3 divided doses; max. 8 mg/kg up to 480 mg daily in 3 divided doses.
Migraine; Prophylaxis: PO
Adult: 80 mg tid-qid.
Paroxysmal supraventricular tachycardia: IV
Adult: 5-10 mg (0.075-0.15 mg/kg) over 2 min; may give additional 10 mg after 30 min if no response.
Pediatric:
(< 1 yr): 0.1-0.2 mg/kg over 2 min, may repeat dose after 30 min.
(1-15 yrs): 0.1-0.3 mg/kg over 2 min, max. 5 mg, may repeat dose after 30 min, max. 10 mg.
Paroxysmal supraventricular tachycardia: PO
Adult: (immediate-release) initial, 240-320 mg daily in 3-4 divided doses; non-digitalized p’ts may require up to 480 mg daily in 3-4 divided doses.
Pediatric: 1-3 mg/kg q8h.
Dose adjustment:
Hepatic failure: 20-50% of normal dose.
Geriatric: initial doses, 40 mg (immediate-release) tid or 120 mg (sustained-release) qd or 100 mg (extended-release) qd hs; give IV at slower rate.
Contraindication:
Atrial fibrillation/flutter associated with accessory bypass tract (Wolff-Parkinson-White, Lown-Ganong-Levine) or short PR syndromes, cardiogenic shock, congestive heart failure (not due to verapamil-sensitive SVT), second or third-degree atrioventricular block (without functioning artificial pacemaker), sick sinus syndrome (without functioning artificial pacemaker), symptomatic hypotension (90 mmHg systolic or less), ventricular tachycardia, wide-complex (QRS 0.12 sec or greater).
Adverse effect:
Common: edema, hypotension, constipation, nausea, dizziness, headache.
Serious: angina, myocardial infarction, syncope.