Acute toxic effects of sustained-release verapamil in chronic renal failure.

Abstract

Four hypertensive patients with chronic renal insufficiency or end-stage renal disease who were treated with sustained-release verapamil hydrochloride subsequently developed acute toxic effects. All four patients developed varying degrees of atrioventricular heart block, hypotension, hyperkalemia, metabolic acidosis, and hepatic dysfunction. Supportive treatment consisted of intravenous catecholamines, sodium polystyrene sulfonate, and dialysis, and all patients recovered completely without any residual hepatic or cardiac disease. Patients with renal impairment who are treated with sustained-release verapamil may accumulate verapamil or its metabolites and develop toxic side effects. We conclude that sustained-release verapamil should be used with caution in this patient population and that patients should be closely monitored for adverse cardiovascular, metabolic, and hepatic side effects.

• Authors: D R Pritza, M H Bierman, M D Hammeke
• Journal: Archives of internal medicine (Arch Intern Med) Vol. 151 Issue 10 Pg. 2081-4 (Oct 1991) ISSN: 0003-9926 [Print] United States
• PMID: 1843183 (Publication Type: Case Reports, Journal Article)

Chemical References

• Delayed-Action Preparations
• Verapamil

Topics

• Delayed-Action Preparations
• Female
• Humans
• Hypertension (complications)
• Kidney Failure, Chronic (complications, drug therapy)
• Male
• Middle Aged
• Monitoring, Physiologic
• Verapamil (adverse effects)