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What Is Transdermal Verapamil 15% Gel?

Transdermal Verapamil 15% Gel is a painless, non-invasive, treatment for fibrotic tissue disorders such as Peyronie's disease that was developed and patented by PDLabs. Since 1998 PDLabs Transdermal Verapamil 15% Gel has been prescribed for over 13,000 patients. It is a prescription compounded medication that is applied directly to the skin twice a day. Verapamil belongs to the class of medications known as calcium channel blockers. The gel has been designed to carry the verapamil through the skin and deliver it to the Peyronie's plaque. The proprietary formula allows for minimal absorption into the blood, while maximizing the concentration of verapamil in the plaque and surrounding tissue.

How Does It Work For Peyronie's Disease?

As with many medications, the exact way Transdermal Verapamil 15% Gel helps Peyronie's disease is not entirely understood. It is proposed that two different processes are taking place. The first allows for the progression of Peyronie's disease to be slowed or stopped and second for the Peyronie's plaque to actually be reduced, which allows for the symptoms of the condition to be reduced or eliminated. Both of these processes are effected by verapamil's ability as a calcium channel blocker to block calcium.

Cells known as fibroblasts are responsible for the production of the primary components of the Peyronie's plaque such as collagen, fibronectin and glycosaminoglycans. Research has shown that the process by which these components are released out of the fibroblast requires calcium. [1] It has been found that calcium channel blockers have the ability to decrease the production of collagen and fibronectin and their release from the fibroblast. [2] A study has also shown that the large increase of Peyronie's fibroblasts is markedly impaired by verapamil, even at low doses. [3] This research is the basis of why it is thought that using Transdermal Verapamil 15% Gel in the inflammatory or early stages of Peyronie's disease, may prevent the condition from being as severe as it might have been without any treatment.

Fibroblasts are also responsible for the production of an enzyme called collagenase. This enzyme is responsible for breaking down or remodeling the excess collagen that makes up Peyronie's plaque. Research has demonstrated that calcium channel blockers such as verapamil have the ability to increase the activity of collagenase, which enhances the remodeling of scars in burn victims. [4] It was also found in experiments with bovine fibroblasts that exposure to verapamil increased collagenase activity. [5] Peyronie's disease is thought to be similar to other wound disorders such as keloids and hypertrophic scars. Research on the use of verapamil in keloids has suggested that it may increase procollagenase production, meaning that verapamil may be capable of increasing collagen breakdown. [6] Although this research was not done on fibroblasts from Peyronie's plaque, it is theorized that fibroblasts from Peyronie's plaque will respond in a similar way. This theory is supported by improvements seen in plaque size when verapamil has been introduced into the Peyronie's plaque. The increase in collagenase activity after exposing the fibroblasts to verapamil helps to explain how Transdermal Verapamil 15% Gel can remodel an already formed and stable Peyronie's plaque into more healthy and elastic tissue. The remodeling of the tissue and return of the elasticity allows for the symptoms of Peyronie's disease to be reduced or eliminated.

The illustration below shows the two proposed mechanisms of action, magnified to the level of the fibroblast.

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The information contained in this website is provided for educational purposes only and is not intended to replace discussions with your healthcare provider. All decisions regarding a patients' treatment must be made with a healthcare provider. PDLabs is not an "internet pharmacy" and requires that an appropriate doctor-patient-pharmacist relationship be maintained. PDLabs will not fill prescriptions for patients that do not have a valid patient-doctor relationship.

Transdermal Verapamil 15% Gel is available as a compounded medication exclusively from PDLabs. Transdermal Verapamil 15% Gel is not FDA approved.

Transdermal Verapamil 15% Gel is not for everyone. Patients with specific heart conditions known as atrioventricular (AV) block or Sino-Atrial (SA) block should not use calcium channel blockers such as verapamil. Patients taking the antiarrhythmic drug Tikosyn® (Dofetilide) should not use Transdermal Verapamil 15% Gel.

Patients taking digoxin or cyclosporine should have their drug levels monitored on a regular basis as verapamil may decrease the metabolism and clearance of these drugs. Patients taking antiarrhythmic drugs should consult with their doctor before taking Transdermal Verapamil 15% Gel to ensure it is safe to use. A PDLabs pharmacist can help with this discussion.

The most common side effect reported with Transdermal Verapamil 15% Gel, affecting 3-5% of Peyronie's disease patients, is varying degrees of skin irritation. Some patients using the medication for the first time may experience mild itching/irritation during the first few days of treatment. This is normal and usually resolves within 3-4 days. Other patients may experience more severe contact dermatitis, including itching, burning, redness, or swelling. More persistent or severe irritation can usually be treated with topical corticosteroids. Based on the individual symptoms, PDLabs will work with the patient and prescribing physician to determine the best course of treatment to resolve irritation.