Verapamil can worsen pre‑existing constipation by reducing gastrointestinal smooth‑muscle contractility. Patients with chronic constipation should be monitored closely and may require prophylactic laxatives or dose adjustment.
Verapamil can markedly slow colonic transit.
Chronic constipation may progress to fecal impaction if not managed.
Prophylactic laxatives are often warranted when starting therapy.
Re‑evaluate the need for verapamil if constipation is refractory.
Verapamil blocks L‑type calcium channels in smooth muscle, decreasing intracellular calcium and leading to reduced contractility of the gastrointestinal tract. This slows colonic transit time, which can exacerbate existing constipation.
Increased severity of constipation, risk of fecal impaction, abdominal discomfort, and potential for bowel obstruction in severe cases. May also reduce patient adherence to therapy due to discomfort.
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