iMedix Medical Content Engine 3.13.37
Home/Drugs/Verelan PM

Verelan PM: Uses, Dosage & Safety Information

Verelan PM

Verelan PM

Verelan PM

Verapamil hydrochloride
Verelan PM is verapamil in a controlled-onset capsule taken at bedtime for high blood pressure. Its peak comes about 11 hours later, in the morning, so the labelling states that a morning or early-afternoon blood pressure reading essentially measures peak effect; the trough is just before bedtime. It is prescription-only.
  • ActiveIngredient: Verapamil hydrochloride
  • DosageForm: Extended-release capsule
  • Dosage: 100 mg, 200 mg, 300 mg
  • Indications: Hypertension
  • Manufacturer: Azurity Pharmaceuticals
  • Storage: Store at 20–25°C
  • Drug Status: Prescription Only
Drug Status: Prescription Only
Description

What is Verelan PM?

A morning reading shows the peak, not the trough
When Verelan PM is taken at bedtime, the labelling states that office evaluation of blood pressure during morning and early afternoon hours is essentially a measure of peak effect. The usual evaluation of trough effect, sometimes needed to judge whether a dose is appropriate, would be just before bedtime.1

The capsule uses a controlled-onset delivery system: its drug release phase is prolonged, with the peak plasma level about 11 hours after a bedtime dose, in the morning hours. Verapamil concentrations rise more than proportionally with dose.1

Like the morning capsule Verelan, it may be opened and its pellets sprinkled onto a tablespoonful of applesauce; the capsule contents must not be crushed or chewed.1

General Instructions

How to Take Verelan PM

Take one capsule once a day at bedtime; all trial doses were given between 9 and 11 pm.1

Swallow whole or sprinkle

Swallow the capsule whole, or open it and sprinkle the entire contents onto a tablespoonful of applesauce. Do not crush or chew the contents. Absorption from other foods has not been tested.1

Blood pressure readings

A reading in the morning or early afternoon mainly reflects the peak effect; a reading just before bedtime reflects the trough. Tell your clinician when a reading was taken.1

Other medicines, alcohol and grapefruit

Tell your doctor about digoxin, a statin or a beta-blocker. Verapamil inhibits alcohol elimination, and grapefruit juice may significantly raise verapamil levels.1

Checking your blood pressure. Because the peak comes in the morning, note the time of each home reading; a late-afternoon reading shows the drug near its lowest level, so compare like with like.

Alcohol and grapefruit. Verapamil can raise blood alcohol levels, and grapefruit juice can raise verapamil levels; keep both moderate.1

Side Effects

What Are the Side Effects of Verelan PM?

In the controlled trials of Verelan PM, the most common reactions occurring in at least 3% and more often than on placebo were headache, infection, constipation, flu syndrome, peripheral oedema, dizziness, pharyngitis and sinusitis.1

Adverse Reactions in Controlled
ReactionAll doses (n=297)Placebo (n=116)
Headache12.1%11.2%
Infection12.1%6.9%
Constipation8.8%0.9%
Flu syndrome3.7%2.6%
Peripheral oedema3.7%0.9%
Dizziness3.0%0.9%
Pharyngitis3.0%2.6%
Sinusitis3.0%2.6%
Dyspepsia2.7%1.7%

Source: 1

Reversible paralytic ileus has been reported infrequently with verapamil.1

Seek immediate medical attention if
You faint or feel your heartbeat become very slow or irregular; you become breathless or develop marked swelling; you develop yellowing of the skin or eyes; or you have severe abdominal pain with no bowel movements.
Uses

What is Verelan PM Used For?

Verelan PM is indicated for high blood pressure, to lower it. Like other extended-release verapamil capsules, it does not carry the angina or arrhythmia indications of immediate-release tablets.12

Source: 1

The trials enrolled 413 evaluable patients with mild to moderate high blood pressure, treated for up to 8 weeks. There were no apparent differences by age above or below 65, sex or race; people with moderate high blood pressure appeared to respond better than those with mild, although subgroup numbers were limited.1

The effect is evident within the first week, and dose changes are judged about 24 hours after a dose.1

Safety Advice

Interactions Alcohol:

Unsafe
Verapamil can raise blood alcohol concentrations and prolong their effect. That matters more on this schedule, because the dose is taken in the evening — the same part of the day people drink.

Interactions Other Medications:

Unsafe
The most serious combination listed is with rate-slowing drugs: beta-blockers, digoxin (major): cardiodepression compounds overnight and into waking. Every other combination, with its effect, is in the Interactions table.

Special Groups Pregnancy:

Consult your doctor
Discuss with your prescriber before or during pregnancy.

Special Groups Breastfeeding:

Consult your doctor
Verapamil is excreted into human milk; discuss breastfeeding with your doctor.

Special Groups Elderly:

Use with caution
Greater sensitivity cannot be ruled out; in rare instances treatment may start at 100 mg.

Special Groups Children:

Consult your doctor
Safety and effectiveness in children have not been established.

Effects on Activities Driving:

Use with caution
Dizziness affected 3.0% in trials. Do not drive until you know how the capsule affects you.

Effects on Activities Operating Machinery:

Use with caution
The same applies. Starting-dose guidance is in the Dosage table.
Warnings

Critical Warnings for Verelan PM Use

Who must not take it

Contraindicated in severe left ventricular dysfunction, systolic pressure below 90 mmHg or cardiogenic shock, sick sinus syndrome or second- or third-degree AV block without a working pacemaker, atrial fibrillation or flutter with an accessory pathway, and hypersensitivity to verapamil.1

Heart, blood pressure and liver

Verapamil can precipitate heart failure, lower blood pressure, slow AV conduction and raise liver enzymes; lower doses and close monitoring are advised with liver impairment.1

Neuromuscular disease

Verapamil may reduce neuromuscular transmission in Duchenne muscular dystrophy and worsen myasthenia gravis; a lower dose may be needed.1

The full warnings for the molecule are on the verapamil page. See Interactions for key combinations.

Dosage

Dosage

Verelan PM Capsules and Labelled Use
ItemLabelled position
Strengths100, 200 and 300 mg capsules; 300 mg is the reference standard
Usual dose200 mg a day at bedtime
Titration300 mg, then 400 mg (two 200 mg capsules) each evening
Increased response possible (kidney or liver impairment, elderly, low weight)In rare instances, start at 100 mg a day
ChildrenSafety and effectiveness not established

Source: 21

Exceeding the dose
The highest trial dose was 400 mg. There is no specific antidote; effects of sustained-release verapamil may be delayed, and people are observed for at least 48 hours, preferably in hospital. Seek emergency help.1
Interactions

What Does Verelan PM Interact With?

Key Interactions of Verapamil
Interacting substanceEffect and riskSeverityDocumentation
DigoxinLevels can rise 50% to 75%; reduce digoxinMajorGood — labelled interaction
SimvastatinDo not exceed 10 mg a dayMajorGood — labelled interaction
Beta-blockersExcess bradycardia and AV block, including complete heart block, reported; monitor closelyMajorGood — labelled interaction
Grapefruit juiceMay significantly increase verapamil levelsModerateGood — labelled interaction
AlcoholAlcohol elimination inhibited; higher ethanol levelsModerateGood — labelled interaction

Source: 1

The full interaction list for the molecule is on the verapamil page.

FAQs
Its controlled-onset system delays and prolongs release, so the peak level comes about 11 hours after a bedtime dose, in the morning hours. All trial doses were given between 9 and 11 pm.
It mainly shows the peak effect. The labelling states that the trough effect, sometimes needed to judge a dose, is evaluated just before bedtime.
Both are extended-release verapamil capsules for high blood pressure that may be sprinkled on applesauce. Verelan is usually taken in the morning, whereas Verelan PM is taken at bedtime and peaks the following morning.
Yes. The entire contents can be sprinkled onto a tablespoonful of applesauce; the contents must not be crushed or chewed, and other foods have not been tested.
Its delayed release is designed so that the highest blood levels come in the early morning hours, which is why a morning reading shows the peak effect.
Evidence and Reported Data

Evidence Scope

What we know
  • Taken at bedtime, Verelan PM peaks about 11 hours later, in the morning hours.1
  • At 200 to 400 mg, trough diastolic pressure fell by 3.8 to 10.0 mmHg more than placebo in 36-hour ambulatory monitoring.1
  • Constipation affected 8.8% against 0.9% on placebo.1
What remains uncertain
  • How it performs if taken in the morning. All trial doses were given at night.
  • Whether other foods work for sprinkling. Absorption from foods other than applesauce has not been tested.
  • How older adults respond. Studies were not adequate to tell; greater sensitivity cannot be ruled out.
  • Use in children. Safety and effectiveness have not been established.

Who was this medicine studied in?

No FDA Drug Trials Snapshot exists: Verelan PM was approved in 1998, and the programme began publishing in 2015.32 Two placebo-controlled trials randomised 413 evaluable patients with mild to moderate high blood pressure; no apparent differences were seen by age, sex or race, though subgroup numbers were limited.1

Who this is and is not appropriate for

Typically considered for: adults with high blood pressure who can take a capsule at bedtime.

Not appropriate for: angina or arrhythmia treatment (not labelled for this capsule); severe left ventricular dysfunction; systolic pressure below 90 mmHg; sick sinus syndrome or high-grade AV block without a pacemaker; atrial fibrillation or flutter with an accessory pathway.1

Product listings and approval status are taken from FDA databases.45

Timing and Exposure Data

What the Trials Showed
Dose at bedtimeEffect in the trials
100 mgNot effective on ambulatory diastolic pressure at trough, but effective when measured manually at trough and peak, from 6 am to noon and over 24 hours
200, 300 and 400 mgConsistently and significantly better than placebo; dose-related trough falls of 3.8 to 10.0 mmHg diastolic

In two placebo-controlled trials, all doses were given between 9 and 11 pm, and blood pressure was measured by 36-hour ambulatory monitoring. At 200, 300 and 400 mg, placebo-subtracted falls in diastolic pressure at trough, averaged over 6 to 10 pm, ranged from 3.8 to 10.0 mmHg after 8 weeks.1

Verelan PM was approved in November 1998 under NDA 020943 and remains on prescription in 100, 200 and 300 mg capsules; the 300 mg strength is the reference standard. The molecule’s contraindications, warnings and interactions are covered under verapamil.2

Where to report and verify

Routing to Official Registries
What you needWhere to go
Report a side effectFDA MedWatch
Pregnancy-specific dataMotherToBaby
Full prescribing informationDailyMed
Verify a pharmacy websiteFDA BeSafeRx · LegitScript
References

References

  1. FDA Prescribing Information, verapamil hydrochloride extended-release capsules (PM), Chartwell (published under NDA 020943, Verelan PM) — Indications, Dosage and Administration, Contraindications, Warnings and Precautions, Adverse Reactions, Drug Interactions, Use in Specific Populations, Overdosage, Clinical Pharmacology, Clinical Studies
    Label effective 2025-03-25 · Accessed 2026-09-27
    Used for: the indication; bedtime dosing, peak and trough evaluation; the controlled-onset pharmacokinetics; the trials; doses and titration; contraindications and warnings; key interactions; the side-effect table; specific populations; and overdose.
    dailymed.nlm.nih.gov — DailyMed
  2. Drugs@FDA — application record for NDA 020943
    Record accessed 2026-09-24
    Used for: the November 1998 approval, the three strengths, the reference standard and current prescription status.
    accessdata.fda.gov — Drugs@FDA
  3. FDA — Drug Trials Snapshots programme scope
    Programme current · Accessed 2026-09-24
    Used for: the basis for stating that no Snapshot exists for a reformulation of an established molecule.
    fda.gov — Drug Trials Snapshots
  4. FDA Orange Book — Verelan PM
    Current edition · Accessed 2026-10-02
    Used for: reference-standard and generic availability.
    accessdata.fda.gov — Orange Book
  5. FDA — Drug Trials Snapshots programme scope
    Programme current · Accessed 2026-10-02
    Used for: confirmation that Snapshots cover novel drugs approved from 2015.
    fda.gov — Drug Trials Snapshots

How this page was sourced

The peak-and-trough statement is quoted from the dosing section that contains it, because it is unusual for a label to tell a reader what a clinic measurement means, and the point would read as commentary if it were paraphrased loosely.

No claim is made that bedtime dosing improves outcomes. The labelling describes the timing of effect, and this page keeps to that.

Material belonging to the molecule is linked rather than restated, so this page remains about the schedule.

FAERS aggregates are not included here. Under §4.13 the block belongs on the page representing the active ingredient. Reports are retrieved by ingredient and cover every verapamil formulation containing it, so they are shown on the verapamil page rather than attached to this brand.

Review cycle. Clinical review completed 2 October 2026. Next review due by 2 October 2027, or earlier if the labelling is revised.

Disclaimer

Disclaimer: The information on this site is provided for informational purposes only and is not medical advice. It does not replace professional medical consultation, diagnosis, or treatment. Do not self-medicate based on the information presented on this site. Always consult with a doctor or other qualified healthcare professional before making any decisions about your health.