Verapamil, a papaverine derivative, inhibits the slow entry of calcium ions into the cell. This entry plays an important role in the development and conduction of the action potential in the conductive system of the heart and in the contraction processes of the cardiovascular cells. Opposed to this, the dihydropyridines (prototype: nifedipine) hardly influence the conductive system. Verapamil causes a delay of the sinus node automaticity, it prolongs the atrioventricular conduction and refractory time, reduces the force of contraction of the myocardium, reduces the peripheral arterial resistance (reduction of after load), and it dilates the coronary vessels.

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