Verapamil deleterious effects in chronic renal failure.
Three hypertensive patients with chronic renal failure treated with slow-release verapamil at the recommended doses for high blood pressure experienced acute deleterious effects shortly after treatment (6 h to 3 days). Patients developed slow cardiac rhythms (junctional bradycardia or atrial fibrillation), hypotension and hyperkalemia. Consequently they also had oliguria and worsening of the renal function. Inotropic support, fluid therapy and potassium-lowering measures were able to restore the renal function and sinus rhythm after 10-12 h. Only 7 similar cases have been described so far. It is suggested that slow-release formulations of verapamil must be used with caution in hypertensive patients with impaired renal function.
Váquez
C
C
Department of Nephrology, Universidad de Navarra, Pamplona, Spain.
Huelmos
A
A
Alegría
E
E
Errasti
P
P
Purroy
A
A
D000368:Aged; D001919:Bradycardia / Q000139:chemically induced; D003692:Delayed-Action Preparations; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*; D014700:Verapamil / Q000008:administration & dosage / Q000009:adverse effects*
D003692:Delayed-Action Preparations; D014665:Vasodilator Agents; D014700:Verapamil