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In healthy manorally administered ISOPTIN undergoes extensive metabolism in the liverTwelve metabolites have been identified in plasmaall except norverapamil are present in trace amounts onlyNorverapamil can reach steadystate plasma concentrations approximately equal to those of verapamil itselfThe cardiovascular activity of norverapamil appears to be approximately 20that of verapamilApproximately 70of an administered dose is excreted as metabolites in the urine and 16or more in the feces within 5 daysAbout 3to 4is excreted in the urine as unchanged drugApproximately 90is bound to plasma proteinsIn patients with hepatic insufficiencymetabolism of immediate release verapamil is delayed and elimination half-life prolonged up to 14 to 16 hourssee PRECAUTIONSthe volume of distribution is increased and plasma clearance reduced to about 30of normalVerapamil clearance values suggest that patients with liver dysfunction may attain therapeutic verapamil plasma concentrations with one third of the oral daily dose required for patients with normal liver function.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effectsMany people using this medication do not have serious side effects.

Bronchospasm and laryngeal spasm occurred during hypersensitivity reactionsRef]

Hemodynamics and Myocardial MetabolismISOPTIN reduces afterload and myocardial contractilityImproved left ventricular diastolic function in patients with IHSS and those with coronary heart disease has also been observed with ISOPTIN therapyIn most patientsincluding those with organic cardiac diseasethe negative inotropic action of ISOPTIN is countered by reduction of afterload and cardiac index is usually not reducedHoweverin patients with severe left ventricular dysfunctione.gpulmonary wedge pressure above 20 mmHg or ejection fraction less than 30or in patients taking beta-adrenergic blocking agents or other cardiodepressant drugsdeterioration of ventricular function may occursee DRUG INTERACTIONS

Asystole occurred after second/third degree AV block and was usually short in durationwith spontaneous cardiac action returning within seconds in the form of a sinus rhythmRef]

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this generic isoptin rx card works for nearly all fda-approved prescription medications, including diabetic test strips, at nearly all pharmacies in the u.

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