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This medication requires careful consideration of warnings and contraindications to ensure safe use. Below are key points that both patients and healthcare providers should be aware of:

• Heart Failure Concerns: Verapamil may exacerbate heart failure, particularly in those with existing cardiac issues affecting blood circulation. Be vigilant for symptoms such as chest discomfort, breathing difficulties, dizziness, fatigue, swelling in the legs and feet, or bloating. Consult your healthcare provider if you experience these symptoms, especially if you are also taking beta-blockers.

• Low Blood Pressure Risk: This medication can significantly lower blood pressure, potentially causing dizziness, fatigue, or lightheadedness, particularly when starting the treatment or increasing the dosage. If you experience extreme dizziness, slowly sit down holding onto a stable object. Immediate medical attention is required if you fall and sustain a head injury. This risk increases when combined with other blood pressure-lowering medications or during dehydration.

• Heart Rate Concerns: Verapamil may induce or worsen heart block, leading to a slower heart rate, which might make you feel weak or cause fainting. This is more probable if you are taking medications like digoxin or beta-blockers, or if you have other conditions affecting heart rhythm. Ensure your healthcare provider is fully informed of your medical history before starting this medication.

• Liver Health Monitoring: In rare cases, verapamil can elevate liver enzymes, potentially resulting in liver issues if untreated. Monitoring liver function tests prior to and regularly during treatment is advisable. Seek immediate medical care if you experience severe nausea, vomiting, right upper abdominal pain, fatigue, loss of appetite, or jaundice.

Contraindications, where this medication should not be used, include:

• Severe left-sided heart failure.
• Critically low blood pressure (systolic less than 90 mmHg).
• Cardiogenic shock.
• Sick sinus syndrome, unless a ventricular pacemaker is present.
• Second or third-degree AV block, unless a ventricular pacemaker is present.
• Atrial fibrillation with specific heart pathway conditions.
• Active heart attack with lung congestion.

Please consult your healthcare provider if any of these conditions apply to you to avoid severe health risks.

Common side effects:

• Dizziness
• Constipation
• Nausea
• Headache
• Tiredness
• Low blood pressure
• Swelling in the hands and feet

Less common but important to monitor:

• Trouble breathing
• Rashes
• Flushing

Serious side effects:

• Heart failure symptoms (chest pain, difficulty breathing, swollen legs or feet)
• Dangerously low blood pressure (dizziness, lightheadedness, pale skin)
• Liver problems (persistent nausea, vomiting, right-sided abdominal pain, fatigue, loss of appetite, yellowing of the skin or eyes)
• Severe allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• Colchicine
• Dofetilide
• Eliglustat
• Flibanserin
• Lomitapide

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Abametapir
• Acalabrutinib
• Acebutolol
• Erythromycin
• Clonidine
• Fingolimod

Interactions with low risk that usually do not require a change in therapy:

• Apixaban
• Buspirone
• Cyclosporine
• Lithium
• St John's Wort