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Tell your doctor if your condition does not get better or if it gets worsefor exampleyour blood pressure readings remain high or increase or your chest pain occurs more often

The dose of Isoptin SR should be individualized by titration and the drug should be administered with foodInitiate therapy with 180 mg of sustained-release verapamil HCIIsoptin SRgiven in the morningLowerinitial doses of 120 mg a day may be warranted in patients who may have an increased response to verapamile.gthe elderly or small people etcUpward titration should be based on therapeutic efficacy and safety evaluated weekly and approximately 24 hours after the previous doseThe antihypertensive effects of Isoptin SR are evident within the first week of therapy.

Treatment of overdosage should be supportiveBeta adrenergic stimulation or parenteral administration of calcium solutions may increase calcium ion flux across the slow channeland have been used effectively in treatment of deliberate overdosage with verapamilContinued treatment with large doses of calcium may produce a responseIn a few reported casesoverdose with calcium channel blockers that was initially refractory to atropine became more responsive to this treatment when the patients received large dosesclose to 1 gram/hour for more than 24 hoursof calcium chlorideVerapamil cannot be removed by hemodialysisClinically significant hypotensive reactions or high degree AV block should be treated with vasopressor agents or cardiac pacingrespectivelyAsystole should be handled by the usual measures including cardiopulmonary resuscitation.

TheophyllineVerapamil therapy may inhibit the clearance and increase the plasma levels of theophylline.

Check with your doctor immediately if any of the following side effects occur while taking verapamil:

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