International generic name
Drug form and composition
Film-coated tablets. One film-coated tablet contains 80 mg Verapamil hydrochloride.
Solution for injection. One ampoule of 2 ml contains 5 mg Verapamil hydrochloride
(2.5 mg /ml).
Isocor, solution for injection, is used in the treatment of several rhythm disorders,
including: paroxysmal supraventricular tachycardia, atrial fibrillation and flutter
with high-frequency ventricular response (except WPW-syndrome); in the treatment
of hypertensive crisis and acute coronary artery syndromes. Isocor, tablets, is
indicated in patients with stable and unstable angina, manifesting with chest pain
attacks; post myocardial infarction angina pectoris; rhythm disorders (except WPW-syndrome);
Dosage and administration
In adults Isocor, ampoules, is applied intravenously - 5 mg (1 ampoule); if necessary
the same dose could be repeated in 10-minutes interval. The preparation can be used
as an intravenous infusion also, diluted in saline, glucose or levulose solution,
with rate of infusion 5-10 mg per hour - up to 100 mg total dose. In hypertensive
crisis is applied as a slow drop intravenous infusion with rate 0.05-0.1 mg /kg
body weight/h; in case of lack or insufficient effect the dose could be doubled.
In newborns Isocor is applied intravenously in dose 0.75-1 mg (0.3-0.4 ml); in infants
- 0.75-2 mg (0.3-0.8 ml); in 1-5 years children - 2-3 mg (0.8-1.2 ml), 6-14 years
- 2.5-5 mg (1-2 ml). Isocor- film-coated tablets is used orally; maximal daily dose
should not exceed 480 mg. In patients with angina pectoris the usual dose is 80-120
mg, given 2-3 times daily; in arrhythmias 240-320 mg daily, divided in 3-4 takes;
in essential hypertension the initial dose in monotherapy is 80 mg, 2-3 times daily.
Isocor should not be used in cardiogenic shock; acute myocardial infarction;
low blood pressure; low heart rate (below 60 beats per minute); AV-block 2-nd and
3-rd degree; sick sinus syndrome; evident heart failure; the first three mounts
of the pregnancy and during lactation; in neuro-muscular conduction disorders..
Special warnings and precautions
In children Isocor should be administered only after careful consideration of
indications, as a risk of rhythm disorders exists. In patients with disturbed liver
function and muscular dystrophy the dosage of Isocor should be reduced. In long-term
treatment with the preparation is necessary to monitor the liver function. As Isocor
is excreted in the mother milk, the treatment of the nursing women with this medicine
requires discontinuation of the breast-feeding.
Concomitant administration of β-adrenoreceptor blocking agents (propranolol,
atenolol, etc) may cause a bradycardia. Barbiturates (phenobarbital, cyclobarbital)
reduce the preparation activity. Phenytoin reduces the plasma concentration of Isocor.
As the calcium salts antagonize the pharmacology action of Isocor, they could be
used intravenously in order to reduce its side effects. Isocor increases blood concentrations
and effectiveness of theophyllin, cyclosporin, doxorubicin, carbamazepine, and digoxin.
Isocor reduces excretion of the antipyrin and enhances its effectiveness. Concomitant
application of other antihypertensive medicines increases its hypotensive effect,
whereas nonsteroidal anti-inflammatory agents reduce the antihypertensive effect
Following adverse reactions are described: cardiovascular system - heart block,
heart rate decrease, hypotension; nervous system - dizziness, anxiety, fatigue,
headache; gastrointestinal system - constipation, nausea, abdominal discomfort (very
rare); respiratory system - bronchial and laryngeal spasm; blood tests - elevation
of the enzyme level (serum transaminases and alkaline phosphatase); skin and mucous
membranes - itching, allergy rash.
Isocor is a calcium channel blocker, exerting direct action on the myocardium.
It blocks the calcium influx through the slow voltage-dependent calcium channels
in the cell and possesses local anesthetic activity. As a result of the later it
causes a peripheral and coronary vessel dilation and prominent antiarrhythmic effect.
The preparation reduces the oxygen consumption in the myocardium, and in higher
dose possesses antiaggregant activity.
30 film-coated tablets of 80 mg. 10 ampoules of 2ml (5mg).
Film-coated tablets - 3 years. Solution for injection - 2 years