The charts below show the chances of developing various side effects from intralesional verapamil.1-5 Side effects are rare and short term.
Certain/Likely Side Effects (% = Incidence)
SHORT TERM Mild-to-moderate pain during injection | up to 84% |
SHORT TERM Burning during injection | up to 84% |
Studies:
Four studies and a meta-analysis have looked at the side effects of intralesional verapamil treatment.
- Study 1:
- Authors: Ahuja and Chatterjee1
- Total # of patients: 40
- # of female patients: (not reported)
- # of male patients: (not reported)
- Age of patients: 15-60
- Drug and dose: Verapamil, 2.5 mg/ml
- Duration of treatment and follow-up: up to 8 treatments, follow-up for 24 weeks
- Side effects:
- Pain-requiring analgesia: 3.53%
- Study 2:
- Authors: Abedini et al.2
- Total # of patients: 50
- # of female patients: 27
- # of male patients: 23
- Age of patients: 18-65
- Drug and dose: Verapamil, 2.5 mg/ml
- Duration of treatment and follow-up: 6 treatments, follow-up for 3 months
- Side effects:
- Pain during injection: 84%
- Burning during injection: 84%
- Study 3:
- Authors: Belie et al.3
- Total # of patients: 38
- # of female patients: (not reported)
- # of male patients: (not reported)
- Age of patients: (not reported)
- Drug and dose: Verapamil, 2.5 mg/ml
- Duration of treatment and follow-up: 6 treatments, follow-up for 3 months
- Side effects:
- No side effects reported
- Study 4:
- Authors: Mohamed et al.4
- Total # of patients: 20
- # of female patients: 4
- # of male patients: 16
- Age of patients: 18-55
- Drug and dose: Verapamil, 2.5 mg/ml
- Duration of treatment and follow-up: 8 treatments, follow-up for 24 weeks
- Side effects:
- No side effects reported
Study 1: In a study published in 2014 in the Burns, Ahuja and Chatterjee treated 40 patients with keloids and hypertrophic scars with intralesional verapamil or intralesional triamcinolone and compared treatment efficacy and safety. The patients received up to 8 injections of 2.5 mg/ml of verapamil at 3-week intervals or 40 mg/ml of triamcinolone. The researchers regularly followed the patients for 24 weeks. Pain-requiring analgesia was the only side effect reported in the verapamil treatment group. In only 4 out of 113 (3.53%) verapamil injections patients experienced analgesic-required pain, while 2 out of 64 (3.125%) triamcinolone injections required analgesics.1
Study 2: In a study published in 2018 in the journal Burns, Abedini and colleagues treated 50 patients with keloids and hypertrophic scars with intralesional verapamil. The patients received 2.5 mg/ml of verapamil every 3 weeks for up to 6 sessions. Almost all patients reported pain and burning as a side effect of the treatments, but they were mild-to-moderate and did not require discontinuation from the treatment.2
Study 3: In a study published in 2021 in Nigerian Journal of Clinical Practice, Belie and colleagues treated 38 patients with hypertrophic scars with 2.5 mg/ml of verapamil. They reported that verapamil can effectively reduce the size of small-sized keloids without causing any side effects.3
Study 4: In a study published in 2021 in Al-Azhar Med. J.( Medicine), Mohamed and colleagues treated 20 patients with hypertrophic scars with 2.5 mg/ml of verapamil. All patients received 8 intralesional verapamil injections in 2 to 3 weeks intervals and were followed for 24 weeks. The authors reported that verapamil did not cause any side effects.4
Meta-analysis: Wang and colleagues published a meta-analysis that included all clinical trials from 1974 to 2015 which compared the efficacy and safety of verapamil injection for the treatment of keloid and hypertrophic scars with other conventional therapies. They found that adverse effects of verapamil are rare and only minor pain during the injection can occur.5
References
- Ahuja RB, Chatterjee P. Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids. Burns. 40(4), 583-8 (2014).
- Abedini R, Sasani P, Mahmoudi HR, Nasimi M, Teymourpour A, Shadlou Z. Comparison of intralesional verapamil versus intralesional corticosteroids in treatment of keloids and hypertrophic scars: A randomized controlled trial. Burns. 44(6), 1482-8 (2018).
- Belie O, Ugburo AO, Mofikoya BO, T Omidiji OA, Belie MF. A comparison of intralesional verapamil and triamcinolone monotherapy in the treatment of keloids in an African population. Niger J Clin Pract. 24(7), 986-92 (2021).
- O. Mohamed, R., M. Kamel, A., M. Mostafa, O., & A. Gadallah, N. EFFICACY OF INTRALESIONAL VERAPAMIL HYDROCHLORIDE VERSUS INTRALESIONAL TRIAMCINOLONE ACETONIDE IN HYPERTROPHIC SCARS AND KELOIDS. Al-Azhar Medical Journal, 50(4), 2887-900 (2021).
- Wang R, Mao Y, Zhang Z, Li Z, Chen J, Cen Y. Role of verapamil in preventing and treating hypertrophic scars and keloids. Int Wound J. 13(4), 461-8 (2016).