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Ver4.6
Verapamil – Forschung
Überwiegend Mechanismus / Beobachtung
34 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Verapamil sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 2018–2026 mit einer typischen Studiengröße von 150 Teilnehmenden.
Basierend auf 34 Studien · 9 Meta-Analysen · 8 RCTs · 13,513 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Nach Outcome
Type-1 diabetes & beta-cell functionRandomisierte Studien bei neu aufgetretenem Typ-1-Diabetes zeigen einen partiellen Erhalt des stimulierten C-Peptids und einen geringeren Insulinbedarf (adjuvant, Repurposing) · 3-12 Monate
Überwiegend Mechanismus / Beobachtung8 Studien
Safety profile
Überwiegend Mechanismus / Beobachtung5 Studien
Heart & blood pressureSeit Jahrzehnten etablierte Kontrolle von Bluthochdruck, Angina pectoris und supraventrikulären Arrhythmien über vaskuläre Wirkungen und Effekte am AV-Knoten · Stunden bis Wochen
Überwiegend Mechanismus / Beobachtung3 Studien
Aktives Forschungsgebiet
33 Studien in den letzten 5 Jahren · Neueste Meta-Analyse: 2026
20182026
1Meta-Analysen=3,234 · very large study2026
While data for novel agents (insulin and BTX-A) suggest potential, further research with standardized methodologies and longer-term follow-up is crucial to define optimal treatment algorithms.
Sanchez Cruz C, Magallanes Bajana A, de Araujo WM, Ríos CR, Mohamed Khalil MEZ, Medina J, Perozo K, Bentley A, Calderon Martinez E, Romano C. · Annals of medicine (2026)
Statistical significance was set at ( p < 0.05).
Regarding adverse effects, a significant risk reduction was found for BTX-A (RR = 0.29; 95% CI: 0.09-0.95; p = 0.04) and Verapamil (RR = 0.35; 95% CI: 0.14-0.84; p = 0.01) compared to corticoids; others showed no significant effects.
For recurrence, no significant differences were found across interventions, suggesting insufficient evidence.
2Systematische Übersichtn=3,526 · very large study2026
Diltiazem, esmolol, dexmedetomidine, labetalol, and clonidine were effective; dexmedetomidine was associated with reduced MAP the most, and esmolol favored recovery.
Saeed A, Saeed O, Nounou MV, McCoul ED, Najah Q, Saleh S, Barakat O, Wahhab A, Yu L, Elhadi M. · JAMA otolaryngology-- head & neck surgery (2026)
Dexmedetomidine was associated with the most reduced MAP (MD, -30.30 mm Hg; 95% CI, -47.91 to -12.69), followed by clonidine (MD, -28.61; 95% CI, -53.11 to -4.11), esmolol (MD, -27.62; 95% CI, -49.73 to -5.51), and labetalol (MD, -26.54; 95% CI, -47.20 to -5.87).
At 60 minutes, bisoprolol (MD, -58.30; 95% CI, -67.50 to -49.10 beats per minute [bpm]), verapamil (MD, -49.90; 95% CI, -58.98 to -40.82 bpm), and labetalol (MD, -43.89; 95% CI, -54.59 to -33.18 bpm) produced the largest heart rate reductions.
Esmolol (MD, -3.67; 95% CI, -4.21 to -3.13 minutes) and labetalol (MD, -3.64; 95% CI, -4.79 to -2.49 minutes) shortened emergence time.
Conclusion Pharmacological therapies effectively reduced LVOT gradients in oHCM patients to varying degrees, with disopyramide and CMIs showing the highest effect, followed by BBs and CCBs.
Awad K, Pereyra Pietri M, Farina JM, Pathangey G, Abbas MT, Scalia IG, Le Couteur D, Wilanksy S, Lester SJ, Ommen SR, Geske JB, Arsanjani R, Ayoub C. · European heart journal. Cardiovascular pharmacotherapy (2025)
Mean changes in LVOT gradients were pooled as mean differences (MD) with 95% confidence intervals (CIs) in a random-effects model.
Within CMIs, mavacamten had a higher effect than aficamten on gradient reduction; among the included BBs, metoprolol showed the highest gradient reduction, while among CCBs, verapamil was the most effective (inter-action P < 0.01).
Similar results were observed for provocable LVOT gradients.
Further well-designed, large-scale RCTs are required to validate the long-term efficacy and safety of this combined regimen.
Feng X, Zou X, Jiang S, He X, Deng Y, Xie J. · Journal of cosmetic dermatology (2026)
Key outcome data, including the mean percentage change in scar improvement, the excellent clinical response rate (defined as ≥ 75% reduction in scar volume), and the incidence of adverse events, were extracted.
Conclusions Cryotherapy combined with intralesional steroid injection is a viable alternative to other first-line treatments for keloids and hypertrophic scars.
Clinical recommendations should be made cautiously based on specific patient and scar conditions.
Further studies should focus on recruiting a clinically significant number of patients, while ensuring robustness and homogeneity in the methodological design.
Yin F, Ali H, Abdelhalim A, Elhassan HA. · Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery (2026)
Results Across 116 participants, all three studies showed statistically significant improvement in the subjective scores of patients who experienced symptoms in the verapamil group.
The mean differences between the two intervention groups and placebo in SNOT-22 were -19.17 (95% CI: -30.76 to -7.58) and -27.7 (95% CI: -49.36 to -6.05).
On the objective metrics, statistically significant improvement in TNPS or LMS between groups was seen in two out of the three studies (0.01 [p = 0.001], -5.2 [p = 0.02]).
Laborante R, Bianchini E, Ciliberti G, Paglianiti DA, Filomia S, Bianchini F, Galli M, Biondi-Zoccai G, Serruys PW, Crea F, Patti G, Savarese G, Trani C, Burzotta F, D'Amario D. · European heart journal. Cardiovascular pharmacotherapy (2026)
In mixed comparisons, no treatment significantly reduced the incidence of primary efficacy endpoints compared to conventional primary PCI during a mean follow-up of 8 months.
IC administration of tirofiban increased the risk of any bleeding [incidence rate ratio: 1.65 (1.11-2.45)], while IC adenosine increased the risk of peri-procedural AVBs [OR: 2.80 (1.14-6.84)].
Nicorandil reduced the incidence of peri-procedural VF/SVT [OR: 0.31 (0.12-0.81)].
Conclusion and relevance This meta-analysis found that the concomitant therapy of DOACs with diltiazem/verapamil increases the risks of bleeding outcomes compared with the DOAC monotherapy group.
Kido K, Shimizu M, Shiga T, Hashiguchi M. · The Annals of pharmacotherapy (2026)
Background Diltiazem and verapamil are combined p-glycoprotein and moderate CYP3A4 inhibitors which significantly increase the concentrations of direct oral anticoagulants (DOACs) and may increase the risks of bleeding.
The concomitant therapy group was also significantly associated with the lower risk of stroke or systemic embolism compared with the DOAC monotherapy group (OR = 0.83; 95% CI = 0.73, 0.93; I 2 = 0%).
Results A total of 6 studies were included in this meta-analysis.
The marked interindividual variability across all skin parameters demonstrates the complexity of skin reactions.
Anderle K, Deinsberger J, Hübel P, von Aufschnaiter V, Salzer M, Zulus AS, Kubatzki MP, Hochrainer J, Crevenna R, Keilani M, Weber B, Wolzt M, Steiner K, Klang V. · European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences (2026)
Trends towards increased SC hydration after irradiation were noted, but CRS analysis of minimal erythema dose skin sites did not reveal significantly increased water mass within the upper 30 µm of the skin.
Average skin pH increase remained below 10%.
Conclusion The study underlines the need for standardisation of assessment tools for evaluating drug-induced photosensitivity, which complement visual evaluation.
Further randomized studies are necessary to confirm these findings and establish standardized guidelines for combined therapy use.
Musmar B, Orscelik A, Roy JM, Hage S, Adeeb N, Tjoumakaris SI, Gooch MR, Notarianni C, Guthikonda B, Morcos J, Rosenwasser RH, Jabbour P. · Translational stroke research (2025)
Combined BA with IA nimodipine significantly improved clinical outcomes compared to BA alone (OR: 0.07, 95% CI: 0.01-0.68, p = 0.02) without increasing hemorrhagic or ischemic risks.
However, ischemic complications were higher with combined therapy than IA nimodipine alone (OR: 0.04, 95% CI: 0.01-0.40, p < 0.01).
Combined therapy reduced retreatment rates compared to IA verapamil monotherapy (OR: 3.18, 95% CI: 1.15-8.79, p = 0.03).
In conclusion, in a real-world cohort of low-risk patients with HCM, verapamil therapy was not associated with a higher incidence of adverse events than β-blocker therapy.
Pinto G, Chiarito M, Puscas T, Bacher A, Donal E, Reant P, Condorelli G, Hagège A, REMY working group of the French Society of Cardiology. · The American journal of cardiology (2025)
Of 600 patients with HCM, 544 (91%) were treated with BBs and 56 (9%) with verapamil.
At up to 8 years of follow-up (median 3.9 years, interquartile range 2.1 to 5.8), no significant differences were observed in the primary end point (132 [24%] vs 10 [18%] under BBs or verapamil, respectively, hazard ratio 1.84, 95% confidence interval 0.94 to 3.63).
At inclusion, the 2 groups were comparable concerning the presence/amplitude of obstruction and sudden cardiac death risk factors.
14Systematische Übersichtn=1,903 · large study2025
Further study is necessary to get more precise data on NIF and VER.
Ghiami H, Parsapour M, Khalilzadeh S, Rahmani H, Omidkhoda N, Arasteh O. · Naunyn-Schmiedeberg's archives of pharmacology (2025)
Although three studies demonstrated positive effects of nimodipine (NIM) in migraine management, the seven remaining studies revealed controversial results.
Three and one articles evaluating the efficacy and safety of nifedipine (NIF) and verapamil (VER) to other drugs, respectively, reported no special effects.
Conclusion According to reviewed research, FLU appears to have the greatest impact on migraine episodes, whereas NIM outperforms B blockers in terms of migraine prevention.
This strategy may improve patient comfort and procedural outcomes without increasing adverse effects.
Sural S, Döğen ME, Duzel B, Karaca O, Brilakis ES, Gorgulu S. · Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2025)
The verapamil group showed significantly lower rates of clinical RAS (4% vs. 30.7%, p < 0.001) and ultrasonographically defined RAS (10.7% vs. 48%, p < 0.001).
In addition, reductions in proximal and middle radial artery area were significantly smaller in the verapamil group (p < 0.001 for both).
Conclusion Oral verapamil administered 2 h before TRA significantly reduces the rate of radial artery spasm and vasoconstriction.
This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.
Ma F, Wu S, Li S, Zeng Z, Zhang J. · The Korean journal of internal medicine (2024)
Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc.
This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.
This study provides new insights into the mechanisms of these drugs that might be taken into consideration in management of nonobstructive HCM.
Bjerregaard L, Dybro AM, Saaby L, Poulsen SH, Rasmussen TB, Jensen MSK. · Journal of the American College of Cardiology (2026)
Results Thirty-two patients (34% women) aged 54 ± 15 years were included.
The adjusted mean difference in pVO 2 was -1.8 mL/kg/min (P = 0.013) bisoprolol vs verapamil, -2.5 mL/kg/min (P = 0.002) bisoprolol vs placebo and -0.7 mL/kg/min (P = 0.990) verapamil vs placebo.
The peak heart rate was lower with bisoprolol (-37 beats/min; P < 0.001) and with verapamil (-17 beats/min; P < 0.001) compared with placebo.