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Normal sinus rhythm is usually not affectedbut in patients with sick sinus syndromeISOPTIN . may interfere with sinus node impulse generation and may induce sinus arrest or sinoatrial block.

It is not known whether the use of verapamil during labor or delivery has immediate or delayed adverse effects on the fetusor whether it prolongs the duration of labor or increases the need for forceps delivery or other obstetric interventionSuch adverse experiences have not been reported in the literaturedespite a long history of use of verapamil in Europe in the treatment of cardiac side effects of beta-adrenergic agonist agents used to treat premature labor.

LithiumIncreased sensitivity to the effects of lithiumneurotoxicityhas been reported during concomitant verapamil-lithium therapylithium levels have been observed sometimes to increasesometimes to decreaseand sometimes to be unchangedPatients receiving both drugs must be monitored carefully.

Check with your doctor immediately if any of the following side effects occur while taking verapamil:

Do not stop taking this medication without consulting your doctorSome conditions may become worse when this drug is suddenly stoppedYour dose may need to be gradually decreased.

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