Verapamil 80mg

CSA NA – FDA Approved – REMS (N) – Can Ship

Nondihydropyridine Calcium Channel Blocker; Class IV Antiarrhythmic; Antianginal

Verapamil/Isoptin/Calan/Verelan works by blocking the entry of calcium through calcium channels in vascular smooth muscle and the myocardium which causes vascular and coronary vasodilation increasing the delivery of blood and oxygen to the tissue.  It can be compounded into a topical form for off-label use on various circulatory conditions.

Verapamil/Isoptin/Calan/Verelan is officially indicated for hypertension, angina, atrial fibrillation, and supraventricular tachycardia.  It is also prescribed and compounded off-label for Peyronie’s disease and erectile dysfunction.

Do not use if the patient has a conduction abnormality

Use with caution in hepatic disease and/or elevated hepatic enzymes 

Use with caution in hypotension/syncope

Erectile Dysfunction: Apply verapamil topically to the shaft of the penis 30 minutes prior to sexual intercourse. 

Pros

Easy to apply

Minimal to no side effects with transdermal application

Cons

Weak evidence

How Should Verapamil, Isoptin/Calan/Verelan Be Used: Whether it’s a cream, lotion, ointment, gel or paste apply the topical approximately 30 minutes prior to sexual intercourse by spreading it evenly along the shaft of the penis and gently massage it in until it has fully disappeared.  Wash your hands after applying the topical.

What Are the Most Common Side Effects of Verapamil, Isoptin/Calan/Verelan:  Stinging, burning, skin irritation, dryness or redness of the application site may occur.  If any of these effects persist or worsen, tell your doctor and/or pharmacist right away.

Contact Your Doctor if You Ever Experience:  Stop using this medication and contact your doctor if you experience any signs of an allergic reaction such as a rash, hives, blisters, swelling, itching, or burning. 

Pharmaceutical Compounding 

Compounding refers to the practice of preparing a pharmaceutical to meet the unique and special needs of a patient when a commercially available product either does not exist or does not meet those needs.  The U.S. Pharmacopeia Convention (USP) defines compounding as “the preparation, mixing, assembling, altering, packaging and labeling of a drug, drug-delivery device, or a device in accordance with a licensed practitioner’s prescription, medication order, or initiative based on the practitioner/patient/pharmacist relationship in the course of professional practice.”

Pharmaceutical compounding refers to the regulated act of a pharmacist preparing a medication to meet the exact specifications requested by the doctor.  Pharmacists engaged in compounding must follow applicable laws and standards set out by the United States Pharmacopeial (USP) Convention.  USP defines the identity, quality, strength and purity of medications, dietary supplements, and food ingredients that may be used in compounding a preparation.  Manufacturing on the other hand, is the mass production of drug products approved by a government agency such as the FDA or Health Canada to ensure the safety, efficacy, and security of the product.

Pharmacy Compounding Accreditation

The Accreditation Council for Health Care (ACHC) was established in 2007 by eight of the leading pharmacy organizations.  The Pharmacy Compounding Accreditation Board (PCAB) offers the most comprehensive assessment and solution for both nonsterile and sterile pharmacy compounding processes as defined by a specific set of standards based on the USP Convention guidelines.

Click on the following link for further details: https://www.achc.org/

Our PCAB accreditation in combination with our commitment to compliance is at the highest industry standard in North America when it comes to quality and safety.

Well tolerated, most side effects are transient and mild to moderate in nature.  The most common side effects include:

>10%

Central Nervous System: Headache (1% to 12%)

Gastrointestinal: Gingival hyperplasia (<19%), constipation (7% to 12%)

1. What is a compounded preparation?
   Compounded medications are prescriptions that are written by physicians and prepared by specially trained pharmacists.  Compounded medications are not commercially available and are ordered by healthcare professional for a number of reasons: i) meets specific and unique needs of the patient; ii) when the commercial drug is not available; iii) patient is allergic to a component of the commercially available drug formulation; iv) standard treatments have failed and an alternative is needed; v) patient responds better to a compounded formulation.
2. How is a compounded preparation different than a manufactured drug?
   Compounded preparations are customized to the patient whereas manufactured drugs are formulated on a one size fits all approach and leverages mass scale production.  Compounded preparations are only made upon the request of a doctor’s order so there is no inventory management.Manufactured medications are subject to standards and regulations of Federal agencies such as the FDA and Health Canada.  In contrast, the practice of pharmacy is overseen and controlled and regulated by State and Provincial levels in North America.
3. How is a compounded medication different than a generic drug?
   Compounded preparations are not equivalent nor can even be considered a generic drug.  Generic drugs go through a drug application and the manufacturer must demonstrate that the generic drug is identical or bioequivalent to the pioneer drug product and can only be approved after the patent of the pioneer drug has expired.  When the generic drug is approved it can be marketed without the brand name on its label.  Compounded preparations do not undergo the same regulatory hurdles and as a result are readily available to patients upon a doctor’s order.
4. What is the value in receiving a compounded medication?
   Even though compounded medications can be expensive and many private insurance companies no longer reimburse such claims the value of compounded medications can vary from one patient to the next.
5. How do you know if a compounded medication is good and/or stable?
   The expiration dates for compounded preparations are shorter than manufactured products as they are generally intended for immediate use or after a short period of storage.  Compounding pharmacists consult with various informational resources and apply stability data testing to support the assigned beyond use date (BUD).  In cases where no stability information is available to the specific preparation, optimal expiry dates are recommended for nonsterile preparations packaged in hermetically sealed containers that are protected from light and stored at room temperature, unless otherwise recommended.
6. Are all pharmacists trained to prepare compounded medications?
   Most pharmacists do some form of compounding however, complex compounding is generally only performed by specialized pharmacies due to the extensive equipment set-up and training required.  Pharmacists do not receive adequate training from their pharmacy school to handle difficult and complex preparations and must enroll in specific accredited training to maintain their skills and knowledge in the practice and art of compounding.