Manidon

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Manidon

Property Description
Active ingredient Verapamil Hydrochloride
Form Tablet, Extended-Release Capsule, Injectable Solution
Pharmacological class Calcium Channel Blocker (Non-dihydropyridine)
Common use Managing heart rhythm and regulating blood flow
Origin Synthetic Chemical Entity

What Type of Medicine is Manidon (Verapamil Hydrochloride)?

Manidon is a proprietary trade name for a pharmaceutical product whose active substance is the generic compound Verapamil Hydrochloride. It is unequivocally defined as a Calcium Channel Blocker (CCB), an agent clinically recognized for its ability to inhibit the influx of calcium ions into cardiac and vascular smooth muscle cells. This pharmacological classification is essential to its function. Manidon is specifically classified within the non-dihydropyridine pharmacological group, which gives it a distinct ability to influence the heart’s electrical conduction system beyond simple blood vessel relaxation. This critical effect on the heart's rhythm is supported by extensive pharmacological studies, further classifying it as a Group IV Antiarrhythmic Agent. Verapamil Hydrochloride is a fully synthetic chemical entity and is consistently manufactured as a single-active-ingredient product.

Composition, Forms, and General Therapeutic Function

The composition of Manidon is based on Verapamil Hydrochloride combined with either solid pharmaceutical excipients in standard oral tablet and specialized extended-release capsule forms, or dissolved in an aqueous vehicle for the injectable solution. The availability of both immediate-release and extended-release formats supports its use in situations requiring continuous, steady-state medication delivery. The core mechanism involves modulating the influx of calcium ions, which results in two key, clinically recognized benefits: it slows electrical activity through the heart's AV node, and it relaxes the blood vessels (vasodilation). This dual action is generally employed to stabilize an irregular heart rhythm and optimize the efficiency of the cardiovascular system, thereby reducing the heart's overall workload.

Regulatory References

  1. Verapamil | StatPearls (NIH Bookshelf)
  2. Verapamil: MedlinePlus Drug Information

What side effects are possible with Manidon?

Official Safety Profile of Manidon (Verapamil Hydrochloride)

This section details the officially documented adverse reactions and safety characteristics of Manidon, based strictly on government regulatory documents (e.g., FDA Prescribing Information, EMA Summary of Product Characteristics).


Frequency-Classified Adverse Reactions

Adverse reactions are categorized by frequency of occurrence as listed in official labeling:

Classification Examples of Reactions
Common (1 in 10 to 1 in 100) Constipation, Headache, Dizziness, Bradycardia (slow heart rate), Hypotension (low blood pressure), Fatigue, Peripheral oedema (swelling).
Uncommon (1 in 100 to 1 in 1,000) Palpitations, Tachycardia, Abdominal pain.
Rare (1 in 1,000 to 1 in 10,000) Paresthesia (tingling/numbness), Tremor, Somnolence, Vomiting.
Frequency Not Known Cardiac arrest, High-degree Atrioventricular (A-V) Block, Severe Cutaneous Adverse Reactions (SJS/TEN), Angioedema, Paralytic ileus.

System-Organ Classes and Serious Reactions

Official labeling groups adverse effects by the affected body system, including Cardiac Disorders, Vascular Disorders, Gastrointestinal Disorders, Nervous System Disorders, and Hepatobiliary Disorders (e.g., reversible increases in liver enzymes). The following are documented as Serious Adverse Reactions:

  • Cardiac Events: Cardiac Arrest, High-degree A-V Block, New onset or exacerbation of Heart Failure, and Severe Hypotension.
  • Cutaneous Events: Severe skin reactions, including Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN).

Population-Specific Safety Notes and Restrictions

Official documents include specific safety statements for certain groups and conditions:

  • Hepatic Impairment: Requires particular caution and potential dose adjustment due to reduced clearance, increasing the risk of systemic accumulation.
  • Elderly Patients: May experience increased susceptibility to adverse effects, especially bradycardia and hypotension.
  • Safety Restrictions: The medication is restricted (contraindicated) in patients with Severe Hepatic Dysfunction and certain Cardiac Conduction Abnormalities (e.g., specific second- or third-degree A-V block without a pacemaker) due to the risk of exacerbation. Effects such as the worsening of heart failure are officially noted to occur more commonly during the initial period of treatment or dose increases.

Overdose and Emergency Response

Overdose and Immediate Medical Attention

Manidon contains verapamil, a calcium channel blocker. Ingestion of an overdose of this class of medication is considered a medical emergency and carries a significant potential for serious health outcomes, including the risk of severe morbidity and mortality.

Overdose presentations are primarily related to the cardiovascular system. Signs that suggest verapamil toxicity often include profound low blood pressure (hypotension) and a severely slowed or irregular heart rate (bradycardia and conduction abnormalities). Other severe manifestations can include altered mental status, signs of cardiac conduction block, and in the most critical cases, cardiac arrest.

Symptoms may manifest rapidly with immediate-release formulations, typically within one to three hours. However, in cases involving a sustained-release form of the medication, the onset of severe toxicity can be significantly delayed, sometimes for 12 to 16 hours, with peak effects potentially occurring after 24 hours. This delay necessitates prolonged, close medical observation for all suspected ingestions.

If an overdose is suspected or confirmed, immediate, urgent medical attention is required. Due to the life-threatening nature of verapamil toxicity, contact emergency medical services or a poison control center right away. Treatment involves essential life support and specialized measures to stabilize cardiovascular function, and an affected patient will require continuous cardiac monitoring in an intensive care setting.

Therapeutic Uses of Manidon

Manidon (Verapamil) is generally used across several key therapeutic areas. It is applied in domains where additional symptomatic support is needed, focusing on symptoms related to heightened physiological activity and systemic imbalance.

The medication is commonly used to manage essential hypertension (chronic high blood pressure), various forms of angina pectoris (chest pain), and certain supraventricular tachyarrhythmias (rapid, irregular heart rhythms). It is relevant in clinical settings that involve acute or unstable symptom patterns, assisting with management across these conditions characterized by periods of heightened symptoms.

Therapeutic Focus: Palpitations and Chest Discomfort

Manidon is primarily utilized to help reduce the frequency and intensity of uncomfortable symptomatic episodes. For heart rhythm issues, it offers the benefit of assisting with heart rate management, while for angina, it contributes to improved comfort during periods of increased physical exertion. This therapeutic benefit also contributes to easing the long-term strain associated with high blood pressure.

Regulatory References

  1. NIH MedlinePlus Drug Information on Verapamil

Eligibility and Restrictions for Use

Eligibility for Manidon (Verapamil Hydrochloride) Use

Eligibility to use Manidon is strictly governed by regulatory labeling, which defines both allowed and prohibited patient populations based on their underlying cardiovascular and physiological status. Use is established for adults across all approved indications, including hypertension and supraventricular tachyarrhythmias.


Populations Who Must Not Use the Medicine (Contraindications)

Manidon is contraindicated in patients with severe Left Ventricular Dysfunction (e.g., severe heart failure) or Cardiogenic Shock. It must not be used by patients with consistent Hypotension (systolic pressure less than 90 mmHg). Use is also prohibited in those with certain electrical conduction defects, specifically Sick Sinus Syndrome or Second- and Third-Degree Atrioventricular (AV) Block, unless a functioning artificial pacemaker is present. Patients with Atrial Fibrillation or Flutter combined with an accessory bypass tract (like Wolff-Parkinson-White syndrome) are also absolutely excluded.


Restricted and Conditional Use

Usage is conditional in patients with severe hepatic impairment due to delayed drug clearance, requiring caution. For pediatric patients, efficacy and safety are generally not established for most uses. Furthermore, the intravenous formulation is contraindicated in neonates and infants. During pregnancy and lactation, use is generally not recommended unless the potential benefit outweighs the documented risk.

What should I know about interactions with other medicines?

Manidon's active ingredient is known to interact with several types of medicines and products, affecting either its own concentration or the concentration or effects of co-administered agents. The official regulatory interaction profile is structured around two main types of effects:

Official Interaction Statements

  • Pharmacokinetic Interactions: The active substance acts as an inhibitor of the CYP3A4 enzyme and the P-glycoprotein (P-gp) transport system. This inhibition may result in significantly increased blood levels of other medicines that are cleared by these pathways, such as certain HMG-CoA Reductase Inhibitors (Statins) and Cyclosporine. Conversely, co-administration with strong CYP3A4 inducers (e.g., Rifampicin) can lower Manidon's own blood concentrations.
  • Pharmacodynamic Interactions: Combining Manidon with other agents that slow heart rate or depress heart function, such as Beta-blockers or certain Antiarrhythmic Agents (e.g., Flecainide), may result in additive effects on cardiac conduction or contractility. This combination requires careful management.
  • Other Interactions: Concomitant use with Digoxin is documented to increase Digoxin's blood levels, due to reduced clearance, necessitating close therapeutic monitoring. The consumption of Grapefruit Juice is also documented to significantly increase the blood concentration of Manidon.

Interaction-Context Constraints

Category Regulatory Note
Interacting Drug Classes Antiarrhythmics, Beta-blockers, Cardiac Glycosides, CYP3A4 Substrates, CYP3A4 Modulators.
Non-Medicinal Products Grapefruit Juice, Alcohol (can inhibit its elimination).
Population Note Caution is advised in patients with Hepatic or Renal Impairment due to altered drug clearance, which may intensify the risk of interactions.
Interaction Classification Avoid or Use with Caution combinations due to risk of excessive cardiodepressant effects or significant changes in plasma concentrations of co-administered drugs.

Mechanism of Action

Manidon is a pharmacologic agent classified as a dihydropyridine calcium channel blocker. Its primary mechanism of action involves the selective inhibition of L-type and T-type voltage-dependent calcium channels (CaV) located on vascular smooth muscle cells.

The compound acts as a calcium ion influx inhibitor, binding to and slowly dissociating from these channels. This interaction blocks the entry of extracellular calcium ions (Ca^2+) into the smooth muscle cytoplasm. Since the intracellular concentration of calcium is essential for the activation of the contractile machinery, the blockade prevents the sustained contractile state of the smooth muscle tissue.

At the system level, this leads to vasorelaxation and subsequent vasodilation of peripheral arterioles. Manidon exhibits selectivity for vascular tissue, resulting in a reduction in systemic vascular resistance (afterload). Furthermore, it produces renal vasodilation, promoting an increase in natriuresis which contributes to a modification of overall fluid balance.

Dosage and Administration Information

How Manidon is Used: Official Administration Guidelines

Manidon (Verapamil Hydrochloride) is used via two approved routes: oral administration for chronic management and intravenous (IV) injection for acute clinical needs. The choice of administration route depends on the required onset and duration of action.


Administration Routes and Standard Dosing

Administration Route Typical Adult Starting Dose Administration Note
Oral (Immediate-Release) 80 mg three times a day (t.i.d.) Maintenance range is typically 80–120 mg t.i.d.
Oral (Extended-Release) 180 mg once daily (q.d.) Maximum daily dose is generally 480 mg, depending on formulation.
Intravenous (IV) 5 to 10 mg via slow bolus Must be given over at least 2 minutes; may be repeated after 30 minutes.

Oral doses are typically titrated at weekly intervals until the desired response is achieved. The immediate-release form requires multiple daily dosing, while extended-release forms are designed for once-daily use.


Key Administration Instructions

Proper use requires adherence to specific labeled constraints to ensure correct drug delivery and absorption:

  • Extended-Release (ER) Forms: ER tablets must be swallowed whole and must not be crushed, cut, or chewed. Some ER capsules may be swallowed whole or the contents can be sprinkled onto applesauce and swallowed immediately.
  • Intravenous Use: The injection must be administered slowly (over a minimum of 2 minutes, or at least 3 minutes in older adults) and should only be performed in a setting with continuous monitoring.
  • Dose Adjustments: Lower initial doses are mandated for older adults and are recommended for patients with hepatic impairment, potentially requiring a significant reduction from the standard dose.

Recent Clinical Evidence

Research Evidence / Overview of Studies

Research Summary of [DRUG NAME]

Research investigated the use of [DRUG NAME], a non-steroidal anti-inflammatory drug (NSAID). Research has explored the drug in patients with chronic pain.

Studies have evaluated the drug for its potential role in pain associated with osteoarthritis. Preclinical models have been used to investigate the drug's relationship with inflammation. Overall, research is being examined regarding the drug's relationship with reported changes in both pain and swelling.


Key Areas of Study

Osteoarthritis Management

Clinical trials have focused on examining the study data in individuals with osteoarthritis of the knee and hip. A large, randomized controlled trial (RCT) in Europe investigated the drug against a placebo for a 12-week period.

  • Pain Score: The study reported differences in the average change in pain scores between the group receiving the drug and the placebo group.
  • Physical Function: Data from the trial suggested changes in metrics related to walking ability and daily activities.

Rheumatoid Arthritis (RA) Studies

Research explored the drug's relationship with reported changes in morning stiffness in relation to other studied compounds. One investigation focused on individuals with established RA over six months.

  • Joint Swelling: The findings suggested a difference in the number of swollen joints over the study period for the group using [DRUG NAME].
  • Adverse Events: Research in this trial and others reported incidences of adverse events, including findings related to kidney function.

Post-Surgical Pain

A study focusing on post-surgical pain reported findings related to perceived changes in discomfort following orthopedic procedures. One trial examined data from the drug's use in a six-month duration.

Combination Therapy Research

Some trials have evaluated [DRUG NAME] in combination with other disease-modifying anti-rheumatic drugs (DMARDs). Studies were conducted to examine whether the combination was associated with changes in patient mobility and daily function. Results were inconsistent when investigating the combined use of these agents.

Key Studies & References

  1. NSAIDs and Acute Kidney Injury (Medsafe Regulatory Guidance)

Frequently Asked Questions (FAQ)

Common questions about Manidon (FAQ)

Q: What is the main thing Manidon is prescribed for?

Manidon (Verapamil) is indicated in official product information for treating hypertension (high blood pressure), managing angina (chest pain), and addressing certain heart rhythm disorders (arrhythmias). This medication works primarily by regulating blood flow and stabilizing the heart’s electrical activity.


Q: I saw a post saying Manidon makes you tired, is that a common side effect?

According to the regulatory documents, fatigue (a feeling of tiredness) is listed as a commonly reported side effect of Manidon. Sleepiness, or somnolence, is also mentioned among less common effects. Any persistent or concerning fatigue should be monitored and discussed with a healthcare provider.


Q: Can Manidon be taken at the same time as cold and flu medicine?

Official patient guidance advises caution regarding other medications. Cold and flu medicines often contain ingredients that can affect your blood pressure or heart rate, potentially causing an unintended interaction. Official guidance emphasizes the need for professional consultation with a healthcare provider or pharmacist regarding co-administration of over-the-counter medications.


Q: Are there any foods or drinks I need to avoid while on Manidon?

Official information advises against the consumption of Grapefruit Juice because it can significantly increase the level of the medicine in the blood. The potential interaction between alcohol consumption and Manidon should be discussed with a healthcare provider, as it may intensify the effects of the medication.


Q: Can Manidon interact with herbal supplements like St. John's Wort?

Yes, regulatory information notes that the concentration of Manidon may be affected by certain supplements. Specifically, concomitant use with St. John's Wort may reduce the amount of the medication in the body, which could impact its effectiveness. This highlights the importance of discussing all supplements with a healthcare provider.


Q: Can people with liver problems use Manidon?

Manidon is processed more slowly in patients with impaired liver function, which can intensify and prolong its effects. For this reason, official guidelines require caution and may necessitate lower initial doses. The medication is contraindicated (prohibited from being used) for patients who have severe hepatic dysfunction.


Q: Is Manidon safe for use by older adults?

Regulatory documents indicate that older adults may be more susceptible to adverse effects, especially low blood pressure or a slow heart rate. Due to a prolonged elimination time in this population, official guidelines indicate that lower starting doses and careful monitoring are typically implemented by healthcare providers for this population.


Q: Does Manidon need to be taken with food?

Official patient labeling indicates that Manidon can generally be taken with or without food. Official administration notes describe that taking the medication with food may be an option if stomach upset is experienced.


Q: Does Manidon have a risk of causing high blood pressure?

Manidon is prescribed to lower blood pressure by reducing the resistance in blood vessels. While low blood pressure (hypotension) is listed as a possible side effect, high blood pressure (hypertension) is not described as a known adverse reaction to the medicine itself.


Q: Is it common to feel stomach upset when starting Manidon?

According to the official safety profile, gastrointestinal issues are common with this medication. Specifically, constipation and nausea are frequently reported side effects when beginning treatment with Manidon.


Q: What does 'contraindication' mean in relation to Manidon?

A contraindication is a specific condition or situation where using a medication carries an unacceptable level of risk and it is prohibited from being used. For Manidon, this relates to certain severe heart conditions and very low blood pressure.


Q: How is Manidon eliminated from the body?

Official pharmacokinetic data describes how the body gets rid of the medication. Manidon is mostly eliminated after being broken down by the liver, with the resulting inactive substances being primarily excreted via the urine and, to a lesser extent, the feces.


Q: Can Manidon interact with common over-the-counter pain relievers?

While specific brand names are not individually listed in regulatory documents, the official label warns against combining Manidon with certain drug classes. Regulatory caution regarding drug interactions emphasizes the need for professional consultation with a healthcare provider or pharmacist prior to co-administering any over-the-counter pain relievers.


Q: Does Manidon change mood or behavior?

Regulatory information lists central nervous system effects such as dizziness and somnolence (sleepiness). Additionally, confusion is listed as a possible symptom in cases of overdose. General changes in mood or behavior are not commonly listed as adverse reactions.


Q: Does Manidon cause weight gain in most people?

Rapid weight gain may be a sign of fluid retention or worsening heart failure. This is a serious condition, and any rapid, unexplained weight gain should be monitored and discussed with a healthcare provider. Weight gain as a general common side effect is not listed.


Q: How long does it typically take before Manidon starts to work?

For high blood pressure treatment, the full pressure-lowering effects are typically noticeable within the first week of therapy. For the intravenous (IV) solution used in emergency clinical settings, the peak therapeutic effects occur rapidly, within 3 to 5 minutes.


Q: What happens if you stop taking Manidon suddenly?

Official patient information advises against suddenly stopping Manidon without the direct instruction of a healthcare provider, especially if it has been used long-term. Abrupt discontinuation can lead to a rapid worsening or rebound of the underlying condition being treated.


Q: Is Manidon a long-term treatment or just for a short time?

Manidon is typically prescribed as a long-term treatment to help control chronic conditions such as high blood pressure and angina. It is generally not used for short-term courses, and there is usually no limitation on the duration of use.


Q: Is Manidon addictive or habit-forming?

No, Manidon is not classified as a federally controlled substance by regulatory bodies and is not generally associated with drug dependence or habit-forming behavior.


Q: Is Manidon considered a controlled substance?

No, Manidon is not listed on any of the controlled substance schedules established by governmental bodies.


Q: Can Manidon affect the results of lab tests?

Healthcare providers may order lab tests, such as checks on blood pressure and liver function, to monitor the body’s response to the medication. It is important to inform all laboratory personnel and healthcare staff that Manidon is being taken, as it may interfere with some test results.


Q: How long does Manidon stay in your system after the last dose?

The elimination half-life (the time it takes for the concentration to reduce by half) is approximately 12 hours. However, the half-life can be prolonged in older adults or those with impaired liver function, meaning the medicine may stay in the system longer.


Q: I heard Manidon is used for pain relief, is that one of its uses?

The officially approved uses for Manidon are specific to cardiovascular conditions, including the management of high blood pressure, angina, and certain arrhythmias. Pain relief is not an officially approved indication for this medication.


Q: Do I need a special prescription to get Manidon?

Yes, Manidon is a prescription-only medicine (POM). It is a potent pharmacological agent and requires a valid prescription from a licensed healthcare provider before it can be dispensed.


Q: Are there any warnings about driving or operating machinery while on Manidon?

Official patient information states that Manidon may cause side effects like dizziness or somnolence (sleepiness), which could impair your ability to drive or operate machinery safely. The official warning advises that driving or operating machinery should be avoided until the individual knows how the medication affects them.


Q: Is there a version of Manidon that is liquid instead of a tablet?

Manidon is generally available as immediate-release tablets, extended-release capsules or tablets, and as an injectable solution for acute clinical use. A simple liquid-for-swallowing oral solution is typically not listed among the main dosage forms.


Q: What is the purpose of the black box warning on Manidon?

The regulatory documents for Manidon as a single-ingredient product do not contain a Black Box Warning. This type of warning is the most stringent required by regulators to call attention to serious or life-threatening risks.

How should Manidon be stored and disposed of?

Storage and Disposal Requirements for Manidon (Verapamil Hydrochloride)

Storage Classification Requirement
Temperature Store at Controlled Room Temperature, defined as 20 C to 25 C. Do not freeze.
Protection Keep protected from light and moisture.
Container Preserve in the tightly closed container as supplied.
Child Safety Keep out of the sight and reach of children.

All forms of Manidon must be kept in a dry, cool, and well-ventilated place, away from excessive heat or freezing. The injectable solution has a specific stability constraint, as it is known to precipitate if mixed with solutions where the pH is above 6.0. Disposal of unused or expired product and its container must be completed in accordance with local, regional, and national regulations. The product must not be discarded in household trash or disposed of in the sanitary sewer system.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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