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        New Message Board Archives >> Medications, Treatments, Therapies 2002 >> Verapamil Caution
        
(Message started by: Becca on Jul 3^rd, 2002, 1:24pm)

Title: Verapamil Caution
Post by Becca on Jul 3^rd, 2002, 1:24pm

The message below was disseminated to medical and nursing staff by the pharmacy at the hospital where I work. I thought it might be of interest to those who are using high dose Verapamil therapy for Cluster Headache.

Use of Trade Names May Increase Risk of Medication Complications
A case history of a woman with hypertension, who was thought to need a pacemaker, but who was actually experiencing an overdose of verapamil, highlights the danger of using trade names exclusively when prescribing medications, German researchers report.
Writing in the May 13th issue of the Archives of Internal Medicine, Dr. Matthias Schwab, from the Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and colleagues report the case of a 56-year-old woman who was scheduled to undergo pacemaker implantation after suffering from acute dizziness, hypotension, and bradycardia.
The woman, who had a longstanding history of hypertension, had been prescribed 80 mg verapamil in the form of Verasal three times per day by a general practitioner who was "apparently unaware" of the fact that the patient had already been taking 240 mg twice daily of verapamil in the form of Veramex. The patient ended up taking a total of 720 mg of verapamil daily, Dr. Schwab's team notes.
An electrocardiogram on admission to the hospital revealed a third-degree atrioventricular block and a left bundle branch block, which led to the discovery of the verapamil overdose.
Within 3 days of stopping verapamil, the atrioventricular block and a left bundle branch block resolved and blood pressure and renal function were normal. After 5 days the patient was symptom-free and discharged. The patient was prescribed enalapril and hydrochlorothiazide for her hypertension.
"This patient's general practitioner was apparently unaware of the active ingredients of the brands he prescribed," Based on this case Dr. Schwab and colleagues conclude that the use of generic names should always be encouraged. This includes educational interactions between physicians and pharmaceutical companies.

Title: Re: Verapamil Caution
Post by Tom on Jul 3^rd, 2002, 5:42pm

Hi Becca,

thanks a lot for your post - not because of the warning concerning verapamil but before all because quoting Dr. Schwab:

»Based on this case Dr. Schwab and colleagues conclude that the use of generic names should always be encouraged...«

That's the crucial point and a failure of this otherwise venerable web site, too: It calls itself »"Worldwide CH Support Group«, but, concerning meds, everybody posting here almost exclusevely terms and writes brand names - usualy US ones. And this way most names of the mentioned meds are unknown for the rest of the world...but generic names are always the same, all over the world (like verapamil: it's simply "verapamil", everywhere) !

So, mostly, as CHead and MD, when I try to give an advice here, I have to search in the US Drug Directory in the internet to get the generic name of the mentioned drug and to know which drug is concerned - it's boring and unnecessary !

ATB ! Thomas

Title: Re: Verapamil Caution
Post by Drk^Angel on Jul 4^th, 2002, 1:22am

Tom... Well... The reason many ppl on the board uses brand names, is because they're many times easier to remember or spell. You also have to remember that while this is a worldwide website, the ppl on the board don't neccesarily know that other countries use different brand names, or even understand that the meds have a generic name. Please don't belittle the board because some members don't post as clearly as you may wish. I'm sure if you ask someone for the generic name of the med they listed, they'll be happy to tell you.

PFDAN....................... Drk^Angel

Title: Re: Verapamil Caution
Post by Tom on Jul 4^th, 2002, 8:25am

Hi Drk^Angel,

I apologize, I didn't want to act like a school teacher.

Nevertheless, indicating generic names of drugs here wouldn't be wrong...Look at this small list of brand names for verapamil only, and only those from the USA and Germany:

USA: Covera, Calan, Isoptin, Verelan

Germany: Azupamil, Durasoptin, Falicarda, Isoptin, Jenapamil,
Verahexal, Vera-Lich, Veramex, Verasal, Veroptinstad,
Veragamma, Vera , Verabeta,

And now imagine how many brand names for this one substance »verapamil« there are worldwide, and how many more brand names there are alltogether for methysergide + all the triptans + lithium + the antiepileptics + the beta blockers and so on...and how difficult it may be to find out which substance is meant as long as the only information about it is one of its brand names.

ATB ! Thomas

Title: Re: Verapamil Caution
Post by Drk^Angel on Jul 5^th, 2002, 1:04am

I know how confusing the brand names can be, but for some, the script only says the brand name, and the med label may only list the brand name. Many times, the only way someone finds out what the generic name for a med is to read the literature that is sometimes included, and how many ppl reads that?

For an easier way to determine the generic name from the brand name is to go to http://www.rxlist.com/ and type the brand name in the search window on the main page. Unfortuneately, it does a fuzzy search, so it will display alot of unrelated meds, but all you have to do is search for the listing with the brand name you're looking for, and it lists the generic name right blow it. I don't know how many of the non-US brands they may have in their database, but it should work for most of the US brands that ppl here may list. Hopefully this will provide you some assistance while reading the board.

PFDAN....................... Drk^Angel

Title: Re: Verapamil Caution
Post by Tom on Jul 5^th, 2002, 7:38am

Right, I always look onto www.rxlist.com to get the substance name hidden behind the brand name of a US drug.

Thomas

Title: Re: Verapamil Caution
Post by Becca on Jul 5^th, 2002, 8:19am

You are welcome, Tom. Multiple drug names drive me crazy. As a nurse, I have to deal with that constantly. A good drug book is a must - can't easily run to the net at work, but so glad to get that web address from y'all, for looking up some of the newer things.
Gotta go now - its my turn to bail. As reported on the news, we here in South Texas are enjoying an unusual midsummer monsoon. I could not get to work today due to road and bridge conditions. Maybe I'll brush up on my drug names instead....