Verapamil is as effiective as a beta-blocker and more effective than nifedipine for angina pectoris. Through a combination with a beta-blocker one achieves an improvement of physical excercise tolerance in selected patients (no left ventricular failure, no atrioventricular conduction dysfunction). For unstable angina pectoris, verapamil is equally effective as nifedipine. Following a cardiac infarction, verapamil improves the prognosis (fewer infarction relapses, reduced mortality) if there is no pre-existing heart failure.

Verapamil has well documented efficacy for the treatment of tachycardial supraventricular arrhythmias (paroxysmal supraventricular tachycardia, atrial fibrillation with tachyarrhythmias, atrial flutter with rapid conduction) and it is considered the drug of choice for parenteral emergency treatment. Verapamil is one of the standard drugs for the treatment of hypertension especially if an antianginal effect is also desired. Improvement of pain originating from obstructive cardiomyopathy is also documented as well as its efficacy for the prevention of migraine.

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