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Is nausea a side effect of a high dosage of Verapamil?

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Posted on Tue, 14 Oct 2014
Question: hi i have taken verapamil for 3 almost 4 weeks now due to tachycardia. and recently my doctor increased the dose to 3 x 120 mg a day (started on that dose Tuesday) but since yesterday i have been feeling nauseas. Can this be a side effect because of the high dose. Before these pills i used to take procoralan which wasnt enough so they put me on a beta blocker but these caused nighmares cold hand and feets. Is it possible for me to use procoralan with one verapamil a day because one verapamil didnt cause me any nausea?
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Answered by Dr. Sukhvinder Singh (49 minutes later)
Brief Answer:
Don't combined unless under strict supervision.

Detailed Answer:
Dear Madam

1. Nausea is a well reported side effect of verapamil, occurring in nearly 2% of subjects especially at high doses. Hence the nausea may may be related to high dose verapamil intake.

2. It is not advisable to combine verapamil with procoralan (ivabradine) except under strict supervision of your physician. As these two drugs have different mechanism of action on same site in heart , it may decrease your heart rate to very low levels which may be dangerous.

3. Usually when heart rates are very high but they originate from normal site in heart (sinus tachycardia) we try to look for a secondary cause of high rate. These may be smoking, alcohol, anxiety, stress, fever, anti-asthma drugs, thyroid diseases, low hemoglobin, lung diseases etc. Very rarely the cause of such a sinus tachycardia is primary i.e. INAPPROPRIATE SINUS TACHYCARDIA. I would like you to discuss this thing with your doctor. You must avoid any precipitating agent.

4. Since you are having nausea you must discuss it out with your GP, cardiologist or ER physician, whosoever is available. Because if your nausea is related to verapamil, you may develop more serious side effects of the drug. Hence a consultation on priority is a must.

Feel free to discuss further.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Sukhvinder Singh (40 minutes later)
i have already been diagnosed since 2012 with inappropriate sinus tachycardia. i had three ablations one for atrial fibrilation, one for avnrt and one for wpw but even that didnt change my high heart rate so thats why they gave me procoralan. I just want to hear is there a possibility that the nausea might go away after some time
doctor
Answered by Dr. Sukhvinder Singh (2 hours later)
Brief Answer:
Do visit a healthcare facility

Detailed Answer:
Dear Madam
I am so sorry to say that I can not assure you that it will go away with time. The reasons for same is that
1. The exact mechanism of nausea has to ascertained. It should not be a manifestation of some other important side effect like fall in blood pressure.
2. The presence of nausea necessitates that we should watch for other side effects and be alert for other side effects. If I get such a case in my practice reducing the dose of verapamil will be high on cards.
3. The literature is not forthcoming on natural history of nausea caused by verapamil. So we do not have support of literature about the future behavior of this side effect induced by verapamil.
Hence I will still recommend you to visit your nearest healthcare facility and get yourself examined and take a decision as per the assessment of physician.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sukhvinder Singh

Cardiologist

Practicing since :1998

Answered : 1306 Questions

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Is nausea a side effect of a high dosage of Verapamil?

Brief Answer: Don't combined unless under strict supervision. Detailed Answer: Dear Madam 1. Nausea is a well reported side effect of verapamil, occurring in nearly 2% of subjects especially at high doses. Hence the nausea may may be related to high dose verapamil intake. 2. It is not advisable to combine verapamil with procoralan (ivabradine) except under strict supervision of your physician. As these two drugs have different mechanism of action on same site in heart , it may decrease your heart rate to very low levels which may be dangerous. 3. Usually when heart rates are very high but they originate from normal site in heart (sinus tachycardia) we try to look for a secondary cause of high rate. These may be smoking, alcohol, anxiety, stress, fever, anti-asthma drugs, thyroid diseases, low hemoglobin, lung diseases etc. Very rarely the cause of such a sinus tachycardia is primary i.e. INAPPROPRIATE SINUS TACHYCARDIA. I would like you to discuss this thing with your doctor. You must avoid any precipitating agent. 4. Since you are having nausea you must discuss it out with your GP, cardiologist or ER physician, whosoever is available. Because if your nausea is related to verapamil, you may develop more serious side effects of the drug. Hence a consultation on priority is a must. Feel free to discuss further. Sincerely Sukhvinder