Isoptin SR Special Precautions

When treating hypertension with Isoptin SR, monitoring of the patient's blood pressure at regular intervals is required.
Use in Patients with Attenuated (Decreased) Neuromuscular Transmission: It has been reported that verapamil decreases neuromuscular transmission in patients with Duchenne's muscular dystrophy and that verapamil prolongs recovery from the neuromuscular-blocking agent, vecuronium. It may be necessary to decrease the dosage of verapamil when it is administered to patients with attenuated neuromuscular transmission.
Patients with Impaired Renal Function: About 70% of an administered dose of verapamil is excreted as metabolites in the urine. Verapamil is not removed by haemodialysis. Until further data are available, verapamil should be administered cautiously to patients with impaired renal function. These patients should be carefully monitored for abnormal prolongation of the PR interval or other signs of overdosage.
Care should be taken in slight conduction disorders (1st-degree AV block), heart failure (to be treated by the physician before Isoptin SR is taken).
Effects on the Ability to Drive or Operate Machinery: Depending on individual susceptibility, the patient's ability to drive a vehicle or operate machinery may be impaired. This is particularly true in the initial stages of treatment when changing over from another drug and also with respect to the consumption of alcohol.
Use in pregnancy & lactation: During pregnancy (especially in the 1st trimester) and during lactation, Isoptin SR should not be given unless, in the physician's judgement, it is essential for the patient's well being.
Use in children: Safety and efficacy of Isoptin SR in children <18 years have not been established.