Prescription medicine
Verapamil First approved as Isoptin
Verapamil (Isoptin) is a prescription medicine with an FDA approval on record since 1981. FDA's NDC Directory lists it from 43 generic labelers, and pharmacies paid $0.191 per verapamil ER 180 mg tablet in the October 7, 2026 NADAC survey.
- Generic listed
- A presentation discontinued
Check it at the source: the verapamil FDA label on DailyMed (effective April 6, 2026, Zydus Pharmaceuticals (USA) Inc.); the NDA 18485 record on Drugs@FDA; every verapamil label on DailyMed.
Highlights of the record
FDA label of April 6, 2026; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026
Used for
From the label: indications and usageVerapamil hydrochloride extended-release tablets are indicated for the treatment of hypertension, to lower blood pressure.
Forms and strengths
- 40 mg
- 80 mg
- 100 mg
- 120 mg
- 180 mg
- 200 mg
- 240 mg
- 300 mg
- 360 mg
- 2.5 mg/ml
- 5 mg/2ml
- 10 mg/4ml
Tablet; injection (solution); film-coated extended-release tablet; injection; extended-release capsule.
On the market
- Earliest approval on file
- August 12, 1981 Isoptin, Mt Adams; Drugs@FDA’s file, where older or withdrawn approvals can be missing
- Generic approvals
- 62 first November 12, 1985; 25 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 45 of which 43 under generic applications, 3 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- $0.191 per tablet Verapamil ER 180 mg tablet
- Shortage (FDA)
- None current 1 past records
- Recalls by its makers (FDA)
- 7 since 2012 0 Class I among all firms' recalls; latest July 2, 2024; 6 more by firms not listed as its makers
- FAERS reports
- 4,242 through July 30, 2026
What is verapamil used for?
From the label: indications and usageVerapamil hydrochloride extended-release tablets are indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including this drug. Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. […]
Conditions named in the indications of verapamil's FDA labels, with every medicine labeled for each:
From other verapamil labelsHigh blood pressure: INDICATIONS AND USAGE Verapamil hydrochloride extended-release tablets are indicated for the treatment of hypertension, to lower blood pressure.
Atrial fibrillation: Temporary control of rapid ventricular rate in atrial flutter or atrial fibrillation except when the atrial flutter and/or atrial fibrillation are associated with accessory bypass tracts (Wolff-Parkinson-White (W-P-W) and …
Angina: Angina at rest including: - Vasospastic (Prinzmetal's variant) angina - Unstable (crescendo, pre-infarction) angina 2.
FDA pharmacologic class: Calcium Channel Blocker.
Source: FDA drug label (Verapamil hydrochloride), Zydus Pharmaceuticals (USA) Inc., effective April 6, 2026 (SPL set e19ab8d8-dae5-489d-9805-7e7407bea06d), via openFDA; the full label on DailyMed
Is there a generic for verapamil (Isoptin)?
The FDA approved the first generic verapamil on November 12, 1985. 62 generic applications are approved; 25 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists verapamil from 43 labelers under a generic (ANDA) application and from 3 brand labelers. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.
- 1981 earliest approval on file
- 1985 first generic approved
- red ticks recalls
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What do pharmacies pay for verapamil (Isoptin)?
In CMS's NADAC survey of October 7, 2026, pharmacies paid $0.191 per Verapamil ER 180 mg tablet, up 7% from $0.178 on October 8, 2025. Prices per unit in the table differ many-fold by strength, form and brand, so compare like with like. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.
- Verapamil ER 240 mg tablet (generic)
| Strength and form | Brand or generic | Pharmacy cost | 30 tablets, or one pen or vial | 12-month change |
|---|---|---|---|---|
| Verapamil 120 mg tablet | Generic | $0.0887 per tablet | $2.66 | +12% |
| Verapamil 40 mg tablet | Generic | $0.113 per tablet | $3.38 | -13% |
| Verapamil 80 mg tablet | Generic | $0.0732 per tablet | $2.20 | +6% |
| Verapamil ER 120 mg capsule | Generic | $2.75 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $82.48 | +169% |
| Verapamil ER 120 mg tablet | Generic | $0.178 per tablet | $5.33 | -22% |
| Verapamil ER 180 mg capsule | Generic | $2.09 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $62.60 | +60% |
| Verapamil ER 180 mg tablet | Generic | $0.191 per tablet | $5.73 | +7% |
| Verapamil ER 240 mg capsule | Generic | $3.15 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $94.43 | +125% |
| Verapamil ER 240 mg tablet | Generic | $0.176 per tablet | $5.28 | +9% |
| Verapamil ER pm 100 mg capsule | Generic | $4.08 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $122.49 | -8% |
| Verapamil ER pm 200 mg capsule | Generic | $5.64 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $169.06 | +21% |
| Verapamil ER pm 300 mg capsule | Generic | $7.92 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $237.61 | +4% |
| Verapamil SR 120 mg capsule | Generic | $2.75 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $82.48 | +169% |
| Verapamil SR 180 mg capsule | Generic | $2.09 per capsule many times the lowest per-tablet cost; NADAC records the price, not why | $62.60 | +60% |
Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price
Is verapamil in shortage?
No verapamil presentation is listed as in shortage in the FDA Drug Shortage Database (read October 8, 2026); its 1 record is all marked to be discontinued, the latest updated November 21, 2025. ASHP keeps a separate shortage list, which can differ.
| Presentation | Company | Status | Updated |
|---|---|---|---|
| Verapamil Hydrochloride, Injection, 2.5 mg/1 mL (NDC 0409-9633-05) | Pfizer Inc. | To Be Discontinued | November 21, 2025 |
Source: FDA Drug Shortage Database via openFDA, updated October 8, 2026
Has verapamil been recalled?
The FDA's Enforcement Report lists 13 recalls naming verapamil since 2012: 0 Class I (the most serious), 10 Class II, 3 Class III; 2 still ongoing. 6 of them are by firms that FDA's NDC Directory does not list as a maker of verapamil and that hold no application for it in Drugs@FDA, such as compounding pharmacies or bulk-ingredient suppliers; the recall notice names the product recalled. A recall names products and lots, not every product of the medicine.
| Started | Class | Company | Reason |
|---|---|---|---|
| July 2, 2024 | Class III | Zydus Pharmaceuticals (USA) Inc | Cross contamination with other products. |
| March 16, 2023 | Class II | Amerisource Health Services LLC | Failed Dissolution Specifications: Out of specification dissolution results above specified values. |
| January 27, 2023 | Class II | Amerisource Health Services LLC | Failed Dissolution Specification: Out of specification dissolution results at time point zero. The OOS was above specified values. |
| April 13, 2022 | Class II | Mckesson Medical-Surgical Inc. Corporate Office | cGMP deviations: Temperature abuse |
| March 15, 2021 | Class II | Cardinal Health Inc. | CGMP Deviations: Intermittent exposure to temperature excursion during storage. |
| October 19, 2015 | Class II | Western Drug not a listed maker | Lack of Assurance of Sterility |
| July 21, 2015 | Class III | Apotex Inc. | Failed Dissolution Specification: One lot of product did not meet the first stage dissolution specification limits. |
| July 2, 2013 | Class II | Aidapak Services, LLC not a listed maker | Labeling:Label Mixup; VERAPAMIL HCL ER, Tablet, 240 mg may be potentially mislabeled as TRIFLUOPERAZINE HCL, Tablet, 1 mg, NDC 00781103001, Pedigree … |
Source: FDA Enforcement Report (drug recalls) via openFDA, through October 8, 2026
What does the verapamil label say about other medicines?
The verapamil label names 32 other medicines in its interaction, contraindication or warning sections. The labels of 47 other medicines name verapamil. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Aspirin | drug interactions | In a few reported cases, coadministration of verapamil with aspirin has led to increased bleeding times greater than observed with aspirin alone. |
| Atenolol | drug interactions | A variable effect has been seen when verapamil and atenolol were given together. |
| Atorvastatin | drug interactions | Lower starting and maintenance doses of other CYP3A4 substrates (e.g., atorvastatin) may be required as verapamil may increase the plasma concentration of these drugs. |
| Carbamazepine | drug interactions | Carbamazepine: Verapamil therapy may increase carbamazepine concentrations during combined therapy. |
| Cimetidine | drug interactions | The interaction between cimetidine and chronically administered verapamil has not been studied. |
| Cisplatin | drug interactions | The absorption of verapamil can be reduced by the cyclophosphamide, oncovin, procarbazine, prednisone (COPP) and the vindesine, adriamycin, cisplatin (VAC) cytotoxic drug regimens. |
| Clonidine | drug interactions | Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concurrently with verapamil. |
| Cyclophosphamide | drug interactions | The absorption of verapamil can be reduced by the cyclophosphamide, oncovin, procarbazine, prednisone (COPP) and the vindesine, adriamycin, cisplatin (VAC) cytotoxic drug regimens. |
| Cyclosporine | drug interactions | Verapamil therapy may increase serum levels of cyclosporine. |
| Digoxin | drug interactions | Clinical use of verapamil in digitalized patients has shown the combination to be well tolerated if digoxin doses are properly adjusted. |
| Disopyramide | drug interactions | Antiarrhythmic agents: Disopyramide: Until data on possible interactions between verapamil and disopyramide phosphate are obtained, disopyramide should not be administered within 48 hours before or 24 hours after verapamil administration. |
| Erythromycin | drug interactions | Clinically significant interactions have been reported with inhibitors of CYP3A4 (e.g., erythromycin, ritonavir) causing elevation of plasma levels of verapamil while inducers of CYP3A4 (e.g., rifampin) have caused a lowering of plasma levels of verapamil. |
| Everolimus | drug interactions | Co-administration of verapamil with everolimus in 16 healthy volunteers increased the C max and AUC of everolimus by 130% and 250%, respectively. |
| Flecainide | drug interactions | A study in healthy volunteers showed that the concomitant administration of flecainide and verapamil may have additive effects on myocardial contractility, AV conduction, and repolarization. |
Every other medicine the verapamil label names
| Medicine named | Section | What the label says |
|---|---|---|
| Ivabradine | drug interactions | Concurrent use of verapamil increases exposure to ivabradine and may exacerbate bradycardia and conduction disturbances. Avoid co-administration of verapamil and ivabradine. |
| Lithium | drug interactions | Increased sensitivity to the effects of lithium (neurotoxicity) has been reported during concomitant verapamil-lithium therapy; … |
| Lovastatin | drug interactions | Limit the daily dose of lovastatin to 40 mg. |
| Metoprolol | drug interactions | A decrease in metoprolol and propranolol clearance has been observed when either drug is administered concomitantly with verapamil. |
| Paclitaxel | drug interactions | Concomitant administration of R verapamil can decrease the clearance of paclitaxel. |
| Phenobarbital | drug interactions | Phenobarbital: Phenobarbital therapy may increase verapamil clearance. |
| Prazosin | drug interactions | Such an effect was observed in one study following the concomitant administration of verapamil and prazosin. |
| Prednisone | drug interactions | The absorption of verapamil can be reduced by the cyclophosphamide, oncovin, procarbazine, prednisone (COPP) and the vindesine, adriamycin, cisplatin (VAC) cytotoxic drug regimens. |
| Procarbazine | drug interactions | The absorption of verapamil can be reduced by the cyclophosphamide, oncovin, procarbazine, prednisone (COPP) and the vindesine, adriamycin, cisplatin (VAC) cytotoxic drug regimens. |
| Propranolol | drug interactions | A decrease in metoprolol and propranolol clearance has been observed when either drug is administered concomitantly with verapamil. |
| Quinidine | drug interactions | In a small number of patients with hypertrophic cardiomyopathy (IHSS), concomitant use of verapamil and quinidine resulted in significant hypotension. |
| Rifampin | drug interactions | … elevation of plasma levels of verapamil while inducers of CYP3A4 (e.g., rifampin) have caused a lowering of plasma levels of verapamil. |
| Ritonavir | drug interactions | Clinically significant interactions have been reported with inhibitors of CYP3A4 (e.g., erythromycin, ritonavir) causing elevation of plasma levels of verapamil while inducers of CYP3A4 (e.g. … |
| Simvastatin | drug interactions | Co-administration of multiple doses of 10 mg of verapamil with 80 mg simvastatin resulted in exposure to simvastatin 2.5-fold that following simvastatin alone. |
| Sirolimus | drug interactions | Mammalian target of rapamycin (mTOR) inhibitors: In a study of 25 healthy volunteers with co-administration of verapamil with sirolimus, whole blood sirolimus C max and AUC were increased 130% and … |
| Temsirolimus | drug interactions | With concomitant use of mTOR inhibitors (e.g., sirolimus, temsirolimus, and everolimus) and verapamil, consider appropriate dose reductions of both medications. |
| Theophylline | drug interactions | Theophylline: Verapamil may inhibit the clearance and increase the plasma levels of theophylline. |
| Timolol | drug interactions | Asymptomatic bradycardia (36 beats/min) with a wandering atrial pacemaker has been observed in a patient receiving concomitant timolol (a beta-adrenergic blocker) eyedrops and oral verapamil. |
Other labels that name verapamil
- Afatinib
- Amiodarone
- Atazanavir
- Betaxolol
- Bisoprolol
- Buspirone
- Carvedilol
- Clarithromycin
- Cobicistat
- Colchicine
- Cyclobenzaprine
- Dabigatran
- Darifenacin
- Darunavir
- Dienogest and estradiol
- Dofetilide
- Dronedarone
- Drospirenone and estradiol
- Drospirenone and ethinyl estradiol
- Drospirenone and ethinyl estradiol and levomefolate
- Dutasteride
- Efavirenz and emtricitabine and tenofovir disoproxil
- Efavirenz and lamivudine and tenofovir disoproxil
- Eplerenone
- Esmolol
- Ezetimibe
- Fesoterodine
- Fosamprenavir
- Itraconazole
- Labetalol
- Lemborexant
- Lurasidone
- Magnesium sulfate
- Mavacamten
- Midazolam
- Morphine
- Naldemedine
- Naloxegol
- Nebivolol
- Nevirapine
- Nifedipine
- Ponesimod
- Pretomanid
- Silodosin
- Siponimod
- Sotalol
- Tacrolimus
- Talazoparib
- Terazosin
- Tizanidine
- Ubrogepant
- Voclosporin
Source: FDA drug label (Verapamil hydrochloride), Zydus Pharmaceuticals (USA) Inc., effective April 6, 2026 (SPL set e19ab8d8-dae5-489d-9805-7e7407bea06d), via openFDA; the full label on DailyMed
What do FAERS reports show for verapamil?
The FDA Adverse Event Reporting System holds 4,242 reports that list verapamil among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 948 are coded as a death and 1,922 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is.
Reports received each year
The most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026
What else is labeled for the same conditions as verapamil?
72 other medicines are given the same way (oral) and in the same FDA class as verapamil or labeled mainly for the same use (high blood pressure), the same class first. High blood pressure lists all 88 medicines labeled for it, by any route. The first 8 are below. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.
| Medicine | Shared indication | Generic labelers (oral) | Pharmacy cost | Shortage |
|---|---|---|---|---|
| Diltiazem | High blood pressure, Atrial fibrillation, Angina | 42 labelers | $0.144 per capsule 24h ER(cd) 120 mg capsule | A presentation being discontinued |
| Amlodipine | High blood pressure, Angina | 42 labelers | $0.0102 per tablet 5 mg tablet | No current entry |
| Amlodipine and benazepril | High blood pressure | 16 labelers | $0.114 per unit 10-20 mg | No current entry |
| Amlodipine and atorvastatin | High blood pressure, Angina | 6 labelers | $1.34 per unit 10-40 mg | No current entry |
| Amlodipine and olmesartan | High blood pressure | 14 labelers | $0.248 per unit 10-20 mg | No current entry |
| Amlodipine and hydrochlorothiazide and olmesartan | High blood pressure | 8 labelers | $0.776 per unit 20-5-12.5 | No current entry |
| Amlodipine and valsartan | High blood pressure | 9 labelers | $0.330 per unit 10-160 mg | No current entry |
| Amlodipine and hydrochlorothiazide and valsartan | High blood pressure | 5 labelers | $6.09 per tablet 10-160-25 mg tablet | No current entry |
Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)
How does verapamil compare with medicines for the same use?
14 side-by-side pages set verapamil beside a medicine whose label shares a use: approvals, generics, pharmacy cost, warnings and supply.
What next?
- Alternatives to verapamil
- 72 medicines for the same use
- Other calcium channel blockers
- the pharmacologic class, with prices and generics
- Verapamil side effects
- the label's list beside FAERS reports
- Verapamil shortage record
- every presentation, company and date
- Check an interaction
- what two or more labels say about each other