A large burden falls on the heart of pregnant women; its work increases many times over. The pressure begins to rise, the heartbeat increases, and painful sensations in the heart area are possible. Treatment of heart disease requires special care, because taking medications can harm the unborn child. But with the appearance of unpleasant symptoms, the need for medication becomes a necessity. Verapamil during pregnancy is one of the popular medications prescribed by doctors during such an important period.
Every woman should understand that the use of any drugs is possible only with the permission of a doctor. Despite the contraindications indicated in the instructions during this period, in practice the drug is used very often. In simple language, Verapamil is a heart medicine. But its operating principle is very complex. Self-medication with this drug is very dangerous.
Composition of the drug
The active component of Verapamil is the chemical substance of the same name.
The medicine belongs to the class of calcium channel blockers. The mechanism of action of the drug is based on a change in the polarity of the membranes of the cells of the human body. The main target organs of the drug are the heart muscle and the walls of large and medium-sized arteries. The drug has a hypotensive effect - it lowers blood pressure in the bloodstream. The described action is associated with the expansion of the lumen of large vessels. Verapamil relaxes the smooth muscle layer of arteries and veins.
The drug improves blood supply to the heart muscle. The medicine expands the lumen of the coronary arteries, facilitating the flow of oxygen to the myocardium. Thanks to the described effect, the medication reduces pain in the heart area.
Verapamil affects the contractility of the sinus and atrioventricular nodes - pacemakers in the myocardium. Anatomical structures are where the heart rate is formed. By reducing conductivity in them, the drug reduces the pulse and normalizes the rhythm of myocardial contractions.
After oral administration, the medication begins to act within an hour and a half, after intravenous administration - after 3 minutes. The drug is processed in the liver to various metabolites. Verapamil is excreted from the body in 1-3 days through urine and feces.
Why is Verapamil prescribed?
The instructions for Verapamil describe the indications for use.
- treatment and prevention of heart rhythm disorders: paroxysmal supraventricular tachycardia, atrial flutter and fibrillation (tachyarrhythmic variant), supraventricular extrasystole;
- treatment and prevention of chronic stable angina (angina pectoris), unstable angina (angina at rest), vasospastic angina (Prinzmetal's angina, variant angina);
- treatment of arterial hypertension.
During pregnancy, Verapamil is usually used in conjunction with other medications to mitigate their side effects on the cardiovascular system. A typical pairing for the drug is Ginipral, which helps maintain pregnancy when there is a threat of termination, but at the same time increases blood pressure and causes tachycardia.
Prophylactic use of Verapamil prevents the development of severe forms of late gestosis.
Verapamil is usually prescribed in the second half of pregnancy, starting at 20–24 weeks. It is recommended to stop using the drug before 30–36 weeks. It is not used in the first trimester due to the fact that this period is very important for the proper development of the fetus, and any interventions can cause further problems with the child’s health and even threaten his life.
Release form and expiration date
The drug has two main forms of release - tablets and solution for injection. Verapamil is also sold in pharmacies in the form of tablets. The shelf life is 3 years. After its expiration, the use of the medication is strictly prohibited.
Verapamil tablets are available in doses of 40 and 80 mg of the active substance in one piece. There are drugs with a prolonged action - they are eliminated from the body 3-4 times longer. The tablets are white or yellow in color and round in shape. The medicine is sold in cardboard packs and glass bottles.
The injection solution is available in ampoules of 2 milliliters, sold in a cardboard box. One milliliter contains 2.5 milligrams of Verapamil. The drug is a clear, odorless liquid.
Verapamil in all forms should be kept in a cool, dark place away from ultraviolet rays. The optimal storage temperature is 16-24 degrees Celsius. It is strictly forbidden to leave the drug in places accessible to small children.
Indications for use
The most common indication for the use of Verapamil during pregnancy is the treatment of gestational hypertension. The disease has other names - late toxicosis or gestosis. The pathology is characterized by the appearance of protein in the urine, blood pressure levels above 140/90, and edema. Verapamil is prescribed for severe disease when other drugs do not have the desired effect.
The drug is indicated for the relief and prevention of increased blood pressure due to secondary arterial hypertension. The group of diseases includes chronic pathologies of the kidneys, thyroid gland, adrenal glands, and brain.
Attention! The use of Verapamil during pregnancy is indicated only if there is a threat to the life of the expectant mother after consultation with a specialist.
The drug is used to treat pathologies of the blood supply to the fetus - chronic placental insufficiency, intrauterine hypoxia, growth and development retardation. Verapamil dilates blood vessels, promoting the flow of oxygen and nutrients to the body of the unborn child.
As part of complex therapy, Verapamil is prescribed during the threat of spontaneous abortion. The medicine reduces the tone of the uterus and restores placental blood flow. Due to the described effect, the medication prevents abortion.
Less commonly, the drug is used in the treatment of other pathologies. Verapamil is indicated for the relief and prevention of angina attacks. The medicine is prescribed to women with chronic heart pathologies.
The medication is used to treat heart rhythm pathologies. The drug is effective against paroxysmal supraventricular systoles, atrial extrasystole, and sinus tachycardia. Verapamil is used for subaortic stenosis and hypertrophic cardiomyopathy.
Can pregnant women take it?
Paradoxically, the drug Verapamil has not been subjected to laboratory studies for negative effects during pregnancy and breastfeeding. Therefore, doctors still cannot accurately determine the degree of influence of the drug on the unborn child - how much of a threat it poses. Moreover, the drug has been prescribed to pregnant women for several decades.
It was found that the active substances of Verapamil are able to penetrate the fetus through the placenta. What remains unknown is what happens to the substances next. For these reasons, even the instructions for use do not contain the same instructions. Some pharmacological manufacturers claim that taking Verapamil during pregnancy is contraindicated. But others assure that it is possible, but only if there is evidence for it.
Thus, there is no consensus. Therefore, you should take the drug with extreme caution and be sure to consult your gynecologist. Only a doctor, after a thorough examination, can prescribe a drug and develop a dosage on an individual level.
No serious pathological abnormalities were found in a newborn child when a pregnant woman took the drug. But reactions such as a depressed state of the respiratory centers, heart rhythm disturbances and decreased motor activity were noticed immediately after birth.
Effect of the drug on the fetus
During clinical trials on laboratory animals, the toxic effect of Verapamil was discovered. In large dosages, exceeding the maximum allowable by 6 times, the drug contributed to impaired growth and development of the fetus. But in average therapeutic quantities, the medicine does not have a harmful effect on the body of the unborn child.
Verapamil belongs to the “C” class of drugs. The drug should be used during pregnancy if there are serious indications, when the potential benefit outweighs the possible risk. Doctors do not recommend using the medication in the early stages of pregnancy. In the 1st trimester, the laying of all fetal organs occurs. Taking Verapamil may contribute to the formation of congenital anomalies.
In later stages of pregnancy, taking the medication does not pose a threat to the life and health of the fetus. Verapamil is not recommended for use in the last weeks of pregnancy. The drug may have a negative effect on labor.
Is it possible to take Verapamil during pregnancy?
For many years, this medication has been prescribed to pregnant women. But no specialist can give an exact answer to the question of whether taking the drug harms the fetus. The effect of Verapamil has been tested exclusively in practice, but there have never been studies on possible damage to the health of the child. But there is accurate information that the medicine passes through the placenta; further action remains unknown.
Verapamil is prescribed to pregnant women in extreme cases, because... its effect on the fetus has not been fully studied
Pharmacists do not explain this mystery; everyone's opinions are very different. For this reason, the instructions have completely different descriptions in the question of application. In some cases, it is considered a contraindication for girls expecting a child. Others indicate the specifics of admissibility.
Doctors do not give an exact answer whether Verapamil is dangerous or is it still safe.
Instructions for use
It is recommended to take the tablets during or after meals with a glass of clean water. The dosage and duration of taking Verapamil is determined by the doctor. The maximum daily dose is 480 milligrams.
Doctors usually prescribe Verapamil 40 mg 2 times a day at regular intervals. If the effect is insufficient and is well tolerated, it is recommended to increase the single dose to 80-160 milligrams.
The injection solution is used in a hospital setting. During pregnancy, intravenous jet administration of Verapamil is prohibited. Expectant mothers are prescribed a dropper with 5-10 mg of the active substance. Before use, the ampoule with the drug is diluted in a solution of glucose or isotonic sodium chloride.
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Wash, dry and peel the vegetables.
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Salt and add sugar to taste. 5 minutes before the end, pour in the vinegar.
Place the finished green tomato lecho into sterilized jars, roll up and leave upside down until completely cooled.
Contraindications
The drug has a wide range of contraindications. The drug should not be used by persons suffering from hypotension. Verapamil can contribute to a critical reduction in blood pressure.
The medication is contraindicated for certain rhythm disorders:
- atrioventricular block 2 and 3 degrees;
- bradycardia;
- atrial flutter and fibrillation;
- SVC syndrome;
- sinoatrial block.
The drug is prohibited for use by persons who have allergic reactions to its components. Also, Verapamil cannot be used during cardiogenic shock, in case of stage 3 chronic heart failure. The use of the medication is not recommended in the presence of chronic pathologies of the kidneys and liver.
Interaction with other drugs
Verapamil increases the plasma concentration of drugs such as Digoxin, Theophylline, Prazosin, Cyclosporine, Carbamazepine, Quinidine, Valproic acid, as well as muscle relaxants. This is due to suppression of cytochrome P450 metabolism.
With simultaneous administration of Cimetidine, the bioavailability of Verapamil increases by 50%, due to a decrease in hepatic metabolism. This must be taken into account when calculating the dosage: a dose that is half the usual dose may be sufficient.
Medicines containing calcium ions reduce the effectiveness of Verapamil. A similar effect is observed when taking Rifampicin, nicotine, and barbiturates simultaneously. All these substances accelerate metabolic processes in the liver and lead to a decrease in the concentration of Verapamil in plasma. Consequently, the antianginal, hypotensive and antiarrhythmic effects of the drug are reduced.
Bradycardia and AV block may develop when taking Verapamil together with inhaled anesthetics and beta-blockers. The use of these drugs at the same time is prohibited; the break between them should be at least 3-4 hours. The reduction in blood pressure is enhanced when the drug is combined with Prazosin and other alpha-blockers.
Nonsteroidal anti-inflammatory drugs, estrogens and sympathomimetics reduce the hypotensive effect of Verapamil. Disopyramide and Flecainide can only be used one day before or 48 hours after.
Side effects
While taking Verapamil, patients rarely experience side effects. Sometimes the drug contributes to the development of arterial hypotension, weakness, and dizziness. The medication may cause nausea and vomiting, constipation, and abdominal pain.
Some people experience nervousness, lethargy, and drowsiness in response to taking the drug. Verapamil also causes redness of the skin of the face and neck, bleeding gums, and impaired liver function.
In rare cases, while using the drug, allergic reactions such as urticaria or atopic dermatitis occur. Sometimes Verapamil promotes bronchospasm, angioedema, and anaphylactic shock.
In case of an overdose, there is a strong drop in blood pressure to 90/60 mmHg. and below, slow heart rate less than 50 beats per minute, loss of consciousness, myocardial rhythm disturbances. For treatment, doctors use the antagonist Verapamil - calcium gluconate.
Reviews of Verapamil left by pregnant women online
In the vast majority of cases, Verapamil is taken together with Ginipral, as evidenced by many reviews. The drug normalizes heart rhythm, which is disturbed by drugs used to prolong pregnancy, and does not cause side effects.
To reduce the effect on the heart of Genipral, Verapamil was not used. Saw. And there was a tremor, really bad, but without it my heart would have skipped a beat.
Olga (I draw from a photo)
https://www.babyblog.ru/community/post/living/541510
In 1B 6 years ago I took Ginipral + Verapamil - everything was OK. Now I’ve been drinking since 28 weeks, but what else can I do? Necessary. I don't think it's a big deal.
White Swan
https://eva.ru/forum/topic-messages.htm?topicId=2235114
I was also prescribed Veropamil with Ginipral, and the reaction to Veropamil was exactly the same. But I’m generally terribly allergic to medications, so whether to choose a maternity hospital at 34 or be patient, my doctor and I decided that I’d be patient) Because it wasn’t that hellish, of course. I just felt sick, my vision was also blurry, space was shorter. I just lay there after Veropamil, and within an hour at most everything went away. True, he still did not dampen my heart well. It accelerated to 138 beats... True, I already have strong tachycardia. Nothing, I drank for 5 days, the threat was lifted, everything is fine now.
LёN
https://www.baby.ru/community/view/73449/forum/post/38207289/
I took Ginipral and Verapamil throughout my pregnancy from the 26th week. It helps with tachycardia, which was especially noticeable when Ginipral was dripped through an IV. Advice, if you take Verapamil, it is better to buy imported ones, after all, their tablets are cleaner.
ZoyaS +
https://eva.ru/forum/topic-messages.htm?topicId=2235114
Verapamil was prescribed to me together with Ginipral. Somehow it doesn’t help much - my fingers still tremble and I feel weak. Although without him it might have been worse.
Kiev resident
https://www.komarovskiy.net/forum/viewtopic.php?t=4560&start=75
Verapamil's analogs
Ginipral is a drug available in tablet form. It relaxes the muscle layer of the uterus, helping to prevent premature termination of pregnancy. The medicine can be used at any stage of pregnancy.
Nifedipine is an analogue of Verapamil, belonging to the group of calcium channel blockers. The medicine is used to treat gestational arterial hypertension, as well as to treat other causes of increased blood pressure during pregnancy. The drug is approved for use from the 1st trimester of pregnancy under the strict supervision of a specialist.
Dopegit is a medicine that contains the substance Methyldopa. The drug is used to lower blood pressure in various types of hypertension. A special feature of the drug is its safety. Dopegit can be used in the early stages of pregnancy; it does not have a harmful effect on the fetus.
Isoptin is a complete analogue of Verapamil in terms of the active substance. The drug is available in the form of tablets of 40 and 80 mg. The medication is indicated for use from the 2nd trimester of pregnancy.
Overdose
How severe and dangerous the symptoms of an overdose will be depends on the amount of the drug taken, the time of the start of detoxification measures and the age of the woman. The most typical symptoms are a rapid and pronounced decrease in blood pressure, irregular heartbeat, and in severe cases, shock and cardiac arrest occur.
In high doses, Verapamil during pregnancy can cause dizziness, hypokalemia, increased blood sugar, and coma. Kidney function is disrupted, metabolic acid-base imbalance develops, shock with swelling of the lung tissue, and convulsions appear.
At the first signs of an overdose, it is necessary to rinse the stomach as quickly as possible so that absorption of the drug stops. After this, measures are taken to help normalize the functioning of the heart until the ambulance arrives - indirect massage and artificial respiration (if required). Doctors perform cardiac pacing and defibrillation. When the critical condition passes, hemofiltration and plasmaphoresis may be prescribed.
