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Verapamil
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Verapamil
Clinical data
Pronunciation
/vɜːrˈæpəmɪl/
Trade names
various
AHFS/Drugs.com
Monograph
License data
US FDA: Verapamil
Pregnancy
category
US: C (Risk not ruled out)
Routes of
administration
by mouth, intravenous
Drug class
Calcium channel blocker
ATC code
C08DA01 (WHO)
Legal status
Legal status
In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability
35.1%
Metabolism
liver
Elimination half-life
2.8–7.4 hours
Excretion
kidney: 11%
Identifiers
IUPAC name[show]
(RS)-2-(3,4-Dimethoxyphenyl)-5-{[2-(3,4-dimethoxyphenyl)ethyl]-(methyl)amino}-2-prop-2-ylpentanenitrile
CAS Number
52-53-9 Y
PubChem CID
2520
IUPHAR/BPS
2406
DrugBank
DB00661 Y
ChemSpider
2425 Y
UNII
CJ0O37KU29
KEGG
D02356 Y
ChEBI
CHEBI:9948 Y
ChEMBL
CHEMBL6966 Y
ECHA InfoCard
100.000.133
Chemical and physical data
Formula
C27H38N2O4
Molar mass
454.602 g/mol
3D model (JSmol)
Interactive image
Chirality
Racemic mixture
SMILES[show]
N#CC(c1cc(OC)c(OC)cc1)(CCCN(CCc2ccc(OC)c(OC)c2)C)C(C)C
InChI[show]
InChI=1S/C27H38N2O4/c1-20(2)27(19-28,22-10-12-24(31-5)26(18-22)33-7)14-8-15-29(3)16-13-21-9-11-23(30-4)25(17-21)32-6/h9-12,17-18,20H,8,13-16H2,1-7H3 Y
Key:SGTNSNPWRIOYBX-UHFFFAOYSA-N Y
(verify)
Verapamil, sold under various trade names,[1] is a medication used for the treatment of high blood pressure, angina (chest pain from not enough blood flow to the heart), and supraventricular tachycardia.[2] It may also be used for the prevention of migraines and cluster headaches.[3][4] It is given by mouth or by injection into a vein.[2]
Common side effects include headache, low blood pressure, nausea, and constipation.[2] Other side effects include allergic reactions and muscle pains.[5] It is not recommended in people with a slow heart rate or heart failure.[5] It is believed to cause problems for the baby if used during pregnancy.[6] It is in the non–dihydropyridine calcium channel blocker family of medications.[2]
Verapamil was approved for medical use in the United States in 1981.[2] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] Verapamil is available as a generic medication.[2] The wholesale cost in the developing world is about 1.71 to 2.70 USD per month.[8] In the United States a month of treatment costs 25 to 50 USD.[9] Long acting formulations exist.[5]
Contents
1 Medical uses
2 Contraindications
3 Side effects
3.1 Overdose
4 Mechanism of action
5 Pharmacokinetic details
6 Veterinary use
7 Uses in cell biology
8 See also
9 References
10 External links
Medical uses[edit]
Verapamil is used for controlling ventricular rate in supraventricular tachycardia and migraine headache prevention.[10] It is a class-IV antiarrhythmic and more effective than digoxin in controlling ventricular rate.[11] Verapamil is not listed as a first line agent by the guidelines provided by JAMA in JNC-8.[12] However, it may be used to treat hypertension if patient has co-morbid atrial fibrillation or other types of arrhythmia.[13][14]
Verapamil is also used intra-arterially to treat cerebral vasospasm.[15] Verapamil is used to treat the condition cluster headache.[16]
Contraindications[edit]
Use of verapamil is generally avoided in people with severe left ventricular dysfunction, hypotension (systolic blood pressure less than 90 mm Hg), cardiogenic shock, and hypersensitivity to verapamil.[17]
Side effects[edit]
The most common side effect of Verapamil is constipation (7.3%). Other side effects include: dizziness (3.3%), nausea (2.7%), low blood pressure (2.5%), and headache 2.2%. Other side effects seen in less than 2% of the population include: edema, congestive heart failure, pulmonary edema, fatigue, elevated liver enzymes, shortness of breath, low heart rate, atrioventricular block, rash and flushing.[18]
Verelan 300-mg extended-release capsule
Along with other calcium channel blockers, verapamil is known to induce gingival hyperplasia.[19]
Overdose[edit]
Acute overdose is often manifested by nausea, weakness, slow heart rate, dizziness, low blood pressure, and abnormal heart rhythms. Plasma, serum, or blood concentrations of verapamil and norverapamil, its major active metabolite, may be measured to confirm a diagnosis of poisoning in hospitalized patients or to aid in the medicolegal investigation of fatalities. Blood or plasma verapamil concentrations are usually in a range of 50–500 μg/l in persons on therapy with the drug, but may rise to 1–4 mg/l in acute overdose patients and are often at levels of 5–10 mg/l in fatal poisonings.[20][21]
Mechanism of action[edit]
Verapamil's mechanism in all cases is to block voltage-dependent calcium channels.[17] In cardiac pharmacology, calcium channel blockers are considered class-IV antiarrhythmic agents. Since calcium channels are especially concentrated in the sinoatrial and atrioventricular nodes, these agents can be used to decrease impulse conduction through the AV node, thus protecting the ventricles from atrial tachyarrhythmias.
Calcium channels are also present in the smooth muscle lining blood vessels. By relaxing the tone of this smooth muscle, calcium channel blockers dilate the blood vessels. This has led to their use in treating high blood pressure and angina pectoris. The pain of angina is caused by a deficit in oxygen supply to the heart. Calcium channel blockers like verapamil dilate blood vessels, which increases the supply of blood and oxygen to the heart.[22] This controls chest pain, but only when used regularly. It does not stop chest pain once it starts. A more powerful vasodilator such as nitroglycerin may be needed to control pain once it starts.
Pharmacokinetic details[edit]
More than 90% of verapamil is absorbed when given orally,[17] but due to high first-pass metabolism, bioavailability is much lower (10–35%). It is 90% bound to plasma proteins and has a volume of distribution of 3–5 l/kg. It takes 1 to 2 hours to reach peak plasma concentration after oral administration.[17] It is metabolized in the liver to at least 12 inactive metabolites (though one metabolite, norverapamil, retains 20% of the vasodilating activity of the parent drug). As its metabolites, 70% is excreted in the urine and 16% in feces; 3–4% is excreted unchanged in urine. This is a nonlinear dependence between plasma concentration and dosage. Onset of action is 1–2 hours after oral dosage. Half-life is 5–12 hours (with chronic dosages). It is not cleared by hemodialysis. It is excreted in human milk. Because of the potential for adverse reaction in nursing infants, nursing should be discontinued while verapamil is administered.
Verapamil has been reported to be effective in both short-term[23] and long-term treatment of mania and hypomania.[24] Addition of magnesium oxide to the verapamil treatment protocol enhances the antimanic effect.[25] It has on occasion been used to control mania in pregnant patients, especially in the first three months. It does not appear to be significantly teratogenic. For this reason, when one wants to avoid taking valproic acid (which is high in teratogenicity) or lithium (which has a small but significant incidence of causing cardiac malformation), verapamil is usable as an alternative, albeit presumably a less effective one.
Veterinary use[edit]
Intra-abdominal adhesions are common in rabbits following surgery. Verapamil can be given postoperatively in rabbits which have suffered trauma to abdominal organs to prevent formation of these adhesions.[26][27][28] Such effect was not documented in another study with ponies.[29]
Uses in cell biology[edit]
Verapamil is also used in cell biology as an inhibitor of drug efflux pump proteins such as P-glycoprotein.[30] This is useful, as many tumor cell lines overexpress drug efflux pumps, limiting the effectiveness of cytotoxic drugs or fluorescent tags. It is also used in fluorescent cell sorting for DNA content, as it blocks efflux of a variety of DNA-binding fluorophores such as Hoechst 33342. Radioactively labelled verapamil and positron emission tomography can be used with to measure P-glycoprotein function.[31]
See also[edit]
Gallopamil
Tiapamil
References[edit]
Jump up ^ "Verapamil". www.drugs.com. Archived from the original on 1 August 2017. Retrieved 14 December 2016.
^ Jump up to: a b c d e f "Verapamil Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
Jump up ^ Tfelt-Hansen, PC; Jensen, RH (1 July 2012). "Management of cluster headache". CNS Drugs. 26 (7): 571–80. doi:10.2165/11632850-000000000-00000. PMID 22650381.
Jump up ^ Merison, K; Jacobs, H (November 2016). "Diagnosis and Treatment of Childhood Migraine". Current Treatment Options in Neurology. 18 (11): 48. doi:10.1007/s11940-016-0431-4. PMID 27704257.
^ Jump up to: a b c WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 267. ISBN 9789241547659. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
Jump up ^ "Verapamil Use During Pregnancy | Drugs.com". www.drugs.com. Archived from the original on 21 December 2016. Retrieved 14 December 2016.
Jump up ^ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
Jump up ^ "Verapamil HCL". International Drug Price Indicator Guide. Retrieved 8 December 2016.
Jump up ^ Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 156. ISBN 9781284057560.
Jump up ^ Koda-Kimble and Young's Applied Therapeutics: The Clinical Use of Drugs 10th edition. USA: LWW. 2012. pp. 497, 1349. ISBN 978-1609137137.
Jump up ^ Srinivasan, Viswanathan; Sivaramakrishnan, H; Karthikeyan, B (2011). "Detection, Isolation and Characterization of Principal Synthetic Route Indicative Impurities in Verapamil Hydrochloride". Scientia Pharmaceutica. 79 (3): 555–68. doi:10.3797/scipharm.1101-19. PMC 3163365. PMID 21886903.
Jump up ^ James, PA; Oparil, S; Carter, BL; Cushman, WC; Dennison-Himmelfarb, C; Handler, J; Lackland, DT; LeFevre, ML; MacKenzie, TD; Ogedegbe, O; Smith, SC Jr; Svetkey, LP; Taler, SJ; Townsend, RR; Wright, JT Jr; Narva, AS; Ortiz, E (2014-02-05). "2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee (jnc 8)". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. ISSN 0098-7484. PMID 24352797.
Jump up ^ Koda-Kimble and Young's Applied Therapeutics: The Clinical Use of Drugs. LWW; Tenth, North American edition. 2012. pp. 320–22. ISBN 978-1609137137.
Jump up ^ "Management of Cluster Headache". www.aafp.org. American Family Physician. Archived from the original on 13 November 2015. Retrieved 4 November 2015.
Jump up ^ Jun, P.; Ko, N. U.; English, J. D.; Dowd, C. F.; Halbach, V. V.; Higashida, R. T.; Lawton, M. T.; Hetts, S. W. (2010). "Endovascular Treatment of Medically Refractory Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage". American Journal of Neuroradiology. 31 (10): 1911–16. doi:10.3174/ajnr.A2183. PMC 4067264. PMID 20616179.
Jump up ^ Drislane, Frank; Benatar, Michael; Chang, Bernard S.; Acosta, Juan; Tarulli, Andrew (1 January 2009). Blueprints Neurology. Lippincott Williams & Wilkins. pp. 71–. ISBN 978-0-7817-9685-9. Archived from the original on 8 June 2013. Retrieved 14 November 2010.
^ Jump up to: a b c d "CALAN (verapamil) Packet Insert" (PDF). Archived (PDF) from the original on 4 March 2016.
Jump up ^ "G.D. Searle LLC Division of Pfizer Inc". CALAN – verapamil hydrochloride tablet, Package Insert. Pfizer. October 2013. Archived from the original on 7 September 2015. Retrieved 4 November 2015.
Jump up ^ Steele, RM; Schuna, AA; Schreiber, RT (1994). "Calcium antagonist-induced gingival hyperplasia". Annals of Internal Medicine. 120 (8): 663–64. doi:10.7326/0003-4819-120-8-199404150-00006. PMID 8135450.
Jump up ^ Wilimowska, Jolanta; Piekoszewski, Wojciech; Krzyanowska-Kierepka, Ewa; Florek, Ewa (2006). "Monitoring of Verapamil Enantiomers Concentration in Overdose". Clinical Toxicology. 44 (2): 169–71. doi:10.1080/15563650500514541. PMID 16615674.
Jump up ^ Baselt, R. (2008). Disposition of Toxic Drugs and Chemicals in Man (8th ed.). Foster City, California: Biomedical Publications. pp. 1637–39.
Jump up ^ "Verapamil hydrochloride tablet". DailyMed dailymed.nlm.nih.gov. Archived from the original on 2 February 2016. Retrieved 9 November 2015.
Jump up ^ Giannini, AJ; Houser Jr, WL; Loiselle, RH; Giannini, MC; Price, WA (1984). "Antimanic effects of verapamil". The American Journal of Psychiatry. 141 (12): 1602–03. doi:10.1176/ajp.141.12.1602. PMID 6439057.
Jump up ^ Giannini, AJ; Taraszewski, R; Loiselle, RH (1987). "Verapamil and lithium in maintenance therapy of manic patients". Journal of Clinical Pharmacology. 27 (12): 980–82. doi:10.1002/j.1552-4604.1987.tb05600.x. PMID 3325531.
Jump up ^ Giannini, A.James; Nakoneczie, Ann M.; Melemis, Stephen M.; Ventresco, James; Condon, Maggie (2000). "Magnesium oxide augmentation of verapamil maintenance therapy in mania". Psychiatry Research. 93 (1): 83–87. doi:10.1016/S0165-1781(99)00116-X. PMID 10699232.
Jump up ^ Elferink, Jan G.R.; Deierkauf, Martha (1984). "The effect of verapamil and other calcium antagonists on chemotaxis of polymorphonuclear leukocytes". Biochemical Pharmacology. 33 (1): 35–39. doi:10.1016/0006-2952(84)90367-8. PMID 6704142.
Jump up ^ Azzarone, Bruno; Krief, Patricia; Soria, Jeannette; Boucheix, Claude (1985). "Modulation of fibroblast-induced clot retraction by calcium channel blocking drugs and the monoclonal antibody ALB6". Journal of Cellular Physiology. 125 (3): 420–26. doi:10.1002/jcp.1041250309. PMID 3864783.
Jump up ^ Steinleitner, Alex; Lambert, Hovey; Kazensky, Carol; Sanchez, Ignacio; Sueldo, Carlos (1990). "Reduction of primary postoperative adhesion formation under calcium channel blockade in the rabbit". Journal of Surgical Research. 48 (1): 42–45. doi:10.1016/0022-4804(90)90143-P. PMID 2296179.
Jump up ^ Baxter, Gary M.; Jackman, Bradley R.; Eades, Susan C.; Tyler, David E. (1993). "Failure of Calcium Channel Blockade to Prevent Intra-abdominal Adhesions in Ponies". Veterinary Surgery. 22 (6): 496–500. doi:10.1111/j.1532-950X.1993.tb00427.x. PMID 8116206.
Jump up ^ Bellamy, W T (1996). "P-Glycoproteins and Multidrug Resistance". Annual Review of Pharmacology and Toxicology. 36: 161–83. doi:10.1146/annurev.pa.36.040196.001113. PMID 8725386.
Jump up ^ Luurtsema, Gert; Windhorst, Albert D.; Mooijer, Martien P.J.; Herscheid, Jacobus D.M.; Lammertsma, Adriaan A.; Franssen, Eric J.F. (2002). "Fully automated high yield synthesis of (R)- and (S)-[11C]verapamil for measuring P-glycoprotein function with positron emission tomography". Journal of Labelled Compounds and Radiopharmaceuticals. 45 (14): 1199–207. doi:10.1002/jlcr.632.
External links[edit]
MedlinePlus DrugInfo medmaster-a684030
"Verapamil" in Drugs.com
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Niflumic acid
Activators
Carbachol
CFTR
Blockers
Glibenclamide
Lonidamine
Piretanide
Activators
1,7-Phenanthroline
1,10-Phenanthroline
4,7-Phenanthroline
7,8-Benzoquinoline
Ivacaftor
Phenanthridine
Unsorted
Blockers
Bumetanide
Flufenamic acid
Meclofenamic acid
Mefenamic acid
Mepacrine
Niflumic acid
Talniflumate
Tolfenamic acid
Trifluoperazine
Others
TRPs
See here instead.
See also: Receptor/signaling modulators • Transient receptor potential channel modulators
show
v
t
e
Glycine receptor modulators
Receptor
(ligands)
GlyR
Agonists: β-Alanine
β-ABA (BABA)
β-AIBA
Caesium
D-Alanine
D-Serine
GABA
Glycine
Hypotaurine
Ivermectin
L-Alanine
L-Proline
L-Serine
L-Threonine
MDL-27531
Milacemide
Picolinic acid
Propofol
Quisqualamine
Sarcosine
Taurine
Positive modulators: Alcohols (e.g., brometone, chlorobutanol (chloretone), ethanol (alcohol), tert-butanol (2M2P), tribromoethanol, trichloroethanol, trifluoroethanol)
Alkylbenzene sulfonate
Anandamide
Barbiturates (e.g., pentobarbital, sodium thiopental)
Chlormethiazole
D12-116
Dihydropyridines (e.g., nicardipine)
Etomidate
Ginseng constituents (e.g., ginsenosides (e.g., ginsenoside-Rf))
Glutamic acid (glutamate)
Ivermectin
Ketamine
Neuroactive steroids (e.g., alfaxolone, pregnenolone (eltanolone), pregnenolone acetate, minaxolone, ORG-20599)
Nitrous oxide
Penicillin G
Propofol
Tamoxifen
Tetrahydrocannabinol
Triclofos
Tropeines (e.g., atropine, bemesetron, cocaine, LY-278584, tropisetron, zatosetron)
Volatiles/gases (e.g., chloral hydrate, chloroform, desflurane, diethyl ether (ether), enflurane, halothane, isoflurane, methoxyflurane, sevoflurane, toluene, trichloroethane (methyl chloroform), trichloroethylene)
Xenon
Zinc
Antagonists: 2-Aminostrychnine
2-Nitrostrychnine
4-Phenyl-4-formyl-N-methylpiperidine
αEMBTL
Bicuculline
Brucine
Cacotheline
Caffeine
Colchicine
Colubrine
Cyanotriphenylborate
Dendrobine
Diaboline
Endocannabinoids (e.g., 2-AG, anandamide (AEA))
Gaboxadol (THIP)
Gelsemine
iso-THAZ
Isobutyric acid
Isonipecotic acid
Isostrychnine
Laudanosine
N-Methylbicuculline
N-Methylstrychnine
N,N-Dimethylmuscimol
Nipecotic acid
Pitrazepin
Pseudostrychnine
Quinolines (e.g., 4-hydroxyquinoline, 4-hydroxyquinoline-3-carboxylic acid, 5,7-CIQA, 7-CIQ, 7-TFQ, 7-TFQA)
RU-5135
Sinomenine
Strychnine
Thiocolchicoside
Tutin
Negative modulators: Amiloride
Benzodiazepines (e.g., bromazepam, clonazepam, diazepam, flunitrazepam, flurazepam)
Corymine
Cyanotriphenylborate
Daidzein
Dihydropyridines (e.g., nicardipine, nifedipine, nitrendipine)
Furosemide
Genistein
Ginkgo constituents (e.g., bilobalide, ginkgolides (e.g., ginkgolide A, ginkgolide B, ginkgolide C, ginkgolide J, ginkgolide M))
Imipramine
NBQX
Neuroactive steroids (e.g., 3α-androsterone sulfate, 3β-androsterone sulfate, deoxycorticosterone, DHEA sulfate, pregnenolone sulfate, progesterone)
Opioids (e.g., codeine, dextromethorphan, dextrorphan, levomethadone, levorphanol, morphine, oripavine, pethidine, thebaine)
Picrotoxin (i.e., picrotin and picrotoxinin)
PMBA
Riluzole
Tropeines (e.g., bemesetron, LY-278584, tropisetron, zatosetron)
Verapamil
Zinc
NMDAR
See here instead.
Transporter
(blockers)
GlyT1
ACPPB
ALX-1393
ALX-5407 (NFPS)
AMG-747
ASP2535
BIIB-104 (PF-04958242)
Bitopertin (RG1678/RO4917838)
CP-802079
Ethanol (alcohol)
Glycyldodecylamide
GSK1018921
LY-2365109
ORG-24598
ORG-25935 (SCH-900435)
PF-02545920
PF-03463275
Sarcosine
SSR-103,800
SSR-504,734
GlyT2
Amoxapine
Ethanol (alcohol)
NAGly
Opiranserin (VVZ-149)
ORG-25543
VVZ-368
See also
Receptor/signaling modulators
GABA receptor modulators
GABAA receptor positive modulators
Ionotropic glutamate receptor modulators
Pharmacy and pharmacology portal
Medicine portal
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text:
List of political term limits
From Wikipedia, the free encyclopedia
Jump to: navigation, search
This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (September 2007) (Learn how and when to remove this template message)
This is a list of term limits for heads of state, heads of government and other notable public office holders by country.
Contents
[hide]
1 Africa
2 Americas
3 Asia
4 Europe
5 Oceania
6 See also
7 References
8 Sources
Africa[edit]
Country
Head of state/government
[hide]Other
Title
Maximum number of terms
Office
Maximum number of terms
Algeria President Two 5-year terms, since 2016 Constitutional Reform.
Angola President Two 5-year terms, since 2010 Constitutional Reform.
Benin President Two 5-year terms, since 1990 Constitution.
Botswana President Two 5-year terms, since 1966 Constitution.
Burkina Faso President Two 5-year terms, since 2002 Constitutional Reform.
Burundi President Two 5-year terms, since 2005 Constitutional Reform.
Chad President Unlimited 5-year terms, since 2005 Constitutional Reform.
Cameroon President Unlimited 7-year terms, from 2008 Constitutional Reform.
Cape Verde President Two 5-year terms, third term only after 5 years. Prime Minister No term limits
Central African Republic President Two 5-year terms, since 2015 Constitutional Reform.
Comoros President Unlimited 5-year non-consecutive terms, since 2009 Constitutional Reform.
Côte d’Ivoire President Two 5-year terms, since 2000 Constitutional Referendum.
Democratic Republic of the Congo President Two 5-year terms, since 2005 Constitutional Referendum.
Republic of the Congo President Three 5-year terms, since 2015 Constitutional Referendum.
Djibouti President Unlimited 5-year terms, since 2010 Constitutional Reform.
Egypt President Two 4-year terms, since 2011 Constitutional Referendum.
Equatorial Guinea President Two 7-year terms, starting from 2011 Constitutional Reform.
Ethiopia President Two 6-year terms, since 1987 Constitutional Reform Prime Minister No term limits
Eritrea President Two 5-Year terms, since 1993 Constitutional Reform.
Gabon President Unlimited 7-year terms, since 1991 Constitutional Reform.
Ghana President Two 4-year terms, since 1992 Constitutional Referendum.
Gambia President Unlimited 5-year terms, since 1996 Constitutional Reform.
Guinea President Two 5-year terms, since 1996 Constitutional Reform.
Guinea-Bissau President Two 5-year terms, since 1991 Constitutional Reform. Prime Minister No term limits
Kenya President Two 5-year terms, since 1991 Constitutional Reform.
Liberia President Two 6-year terms, since 1986 Constitutional Referendum.
Lesotho King No set terms (Hereditary succession). Prime Minister Unlimited 5-year terms, since 1998 Constititional Reform.
Libya Presidential Council No set terms (Transitional)
Madagascar President Two 5-year terms, since 1992 Constitutional Referendum.
Malawi President Two 5-year terms, since 1995 Constitutional Referendum.
Mali President Two 5-year terms, since 1992 Constitutional Referendum.
Mauritania President Two 5-year terms, since 1991 Constitutional Referendum
Mauritius President Unlimited 5-year terms, since 1991 Constitutional Reform. Prime Minister No term limits
Morocco King No set terms (Hereditary succession) Prime Minister Unlimited 5-year terms, since 2011 Constitutional Reforms.
Mozambique President Two 5-year terms, since 2004 Constitutional Reforms.
Namibia President Two 5-year terms, since 1999 Constitutional Reforms.
Niger President Two 5-year terms, since 2010 Constitutional Referendum.
Nigeria President Two 4-year terms, since 1999 Constitutional Reforms.
Rwanda President Two 5-year terms, since 2015 Constitutional Reform (from 2024).
São Tomé and Príncipe President Two 5-year terms, since 2003 Constitution Reforms. Prime Minister No term limits
Senegal President Two 5-year terms, since 2016 Constitutional Reform.
Seychelles President Two 5-year terms, since 2016 Constitutional Reforms.
Sierra Leone President Two 5-year terms, since 1991 Constitutional Referendum.
Somalia President Two 5-year terms, since 1991 Constitutional Referendum.
South Africa President Two 5-year terms, since 1996 Constitutional Referendum.
South Sudan President Two 5-year terms, proposed.
Sudan President Unlimited 5-year terms, since 2015 Constitutional Reform.
Swaziland King No set terms (Hereditary succession) Prime Minister Unlimited 5-year terms, since 2005 Constititional Reform.
Tanzania President Two 5-year terms, since 1977 Constitutional Reform.
Togo President Unlimited 5-year terms, since 2002 Constitutional Reform.
Tunisia President Two 5-year terms, since 2014 Constitutional Referendum.
Uganda President Unlimited 5-year terms, since 2005 Constitutional Reform.
Sahrawi Arab Democratic Republic President No set terms (In exile)
Zambia President Two 5-year terms, since 2006 Constitutional Reform.
Zimbabwe President Two 5-year terms, since 2013 Constitutional Referendum.
Americas[edit]
Country
Head of state/government
Other
Title
Maximum number of terms
Office
Maximum number of terms
Argentina President Two consecutive 4-year terms. Every former President, if they have already served two consecutive terms in a row, has to wait one complete 4-year term, until they can be re-elected into two consecutive 4-year terms as President of Argentina again. Vice President Two consecutive 4-year terms. Every former Vice President, if they have already served two consecutive terms in a row, has to wait one complete 4-year term, until they can be re-elected into two consecutive 4-year terms as Vice President of Argentina again.
Senators Unlimited 6-year terms.
Deputies Unlimited 4-year terms.
Bolivia President Two 5-year terms Vice President Two 5-year terms
Brazil President Two consecutive 4-year terms. Every former President, if they have already served two consecutive terms in a row, has to wait one complete 4-year term, until they can be re-elected into two consecutive 4-year terms as President of Brazil again. Vice President Two consecutive 4-year terms. Every former Vice President, if they have already served two consecutive terms in a row, has to wait one complete 4-year term, until they can be re-elected into two consecutive 4-year terms as Vice President of Brazil again.
Canada Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, but the Prime Minister must maintain the support of the House of Commons which has a maximum term of 4 years.
Premier No directly set terms, but Premiers must maintain the support of their respective provincial or territorial legislative assemblies which have a maximum term of five years.
Chile President Unlimited non-consecutive 4-year terms
Colombia President Two 4-year terms Vice President Two 4-year terms
Costa Rica President Unlimited non-consecutive 4-year terms
Cuba President Two 5-year terms
Dominican Republic President Two 4-year terms Vice President Two 4-year terms
Ecuador President Two 4-year terms Vice President Two 4-year terms
El Salvador President One 5-year term Vice President One 5-year term
Guatemala President One 4-year term Vice President Unlimited non-consecutive 4-year terms
Guyana President Two 5-year terms
Haiti President Two non-consecutive 5-year terms
Honduras President One 4-year term Vice President One 4-year term
Mexico President One 6-year term (sexenio)
Nicaragua President Unlimited 5-year terms[1] Vice President Unlimited 5-year terms
Panama President Two non-consecutive 5-year terms Vice President Two non-consecutive 5-year terms
Paraguay President One 5-year term Vice President One 5-year term
Peru President Unlimited non-consecutive 5-year terms
Trinidad and Tobago President Two 5-year terms
United States President Two 4-year terms (except after succeeding to the Presidency and serving for more than two years, in which case only one subsequent four-year term is permitted). Eligibility of former term limited presidents is unclear (see article on Twenty-Second Amendment). Vice President Unlimited 4-year terms
Senators Unlimited 6-year terms
Representatives Unlimited 2-year terms
Uruguay President Unlimited non-consecutive 5-year terms Vice President Unlimited non-consecutive 5-year terms
Venezuela President Unlimited 6-year terms National Assembly Unlimited 5-year terms
Asia[edit]
Country
Head of state/government
Other
Title
Maximum number of terms
Office
Maximum number of terms
Afghanistan President Two 5-year terms Chief Executive 5 years Ad hoc
Bangladesh President Two 5-year terms Prime Minister No term limits
Cambodia King No set terms (Hereditary succession) Prime Minister No term limits
Vietnam President (Head of state) One 5-year term Prime Minister (Head of government) Two 5-year terms
China President (Head of state) Two consecutive 5-year terms[2] (Two terms of National People's Congress session) Premier (Head of government) Two 5-year terms[2] (Two terms of National People's Congress session)
Hong Kong Chief Executive Two 5-year terms Members of the Legislative Council Unlimited 4-year terms
India President Unlimited 5-year terms Prime Minister No directly term limits, however they must maintain the support of the Indian Parliament which has a term of five years
Indonesia President Two 5-year terms Vice President Two 5-year terms
Iran President Two consecutive and one non-consecutive 4-year terms
Iraq President Two 4-year terms Prime Minister Unlimited 4-year terms
Israel President One 7-year term Prime Minister Between 1948 and 1996, and since 2001: No directly set terms, however they must maintain the support of the Knesset which has an undefined term not exceeding four years.
Between 1996 and 2001 (when the Prime Minister was directly elected): Unlimited undefined terms. Should these terms exceed seven years, the Prime Minister will not be eligible for immediate re-election.
Japan Prime Minister 4-years term with no limit restrictions on number of terms served
Member of the House of Councillors Unlimited 6-year terms
Member of the House of Representatives Unlimited maximum 4-year terms
Kazakhstan President Two consecutive 5-year terms (Exception for first President)
Kyrgyzstan President One 6-year term
Laos President Two 5-year terms
Lebanon President Unlimited non-consecutive 6-year terms Prime Minister No term limits
Macau Chief Executive Two 5-year terms Legislative Council Unlimited 4-year terms
Malaysia Monarch Unlimited 5-Year Terms, but because the 9 Sultans of the Malayan provinces rotate each time between themselves, the unlimited 5-Year Terms are de facto unlimited non-consecutive 5-year terms. Prime Minister No term limits
Maldives President Two 5-year terms (starting 1998)
Mongolia President Two 4-year terms Prime Minister No term limits
Pakistan President Two 5-year terms Prime Minister No term limits
Philippines President One 6-year term Vice President Two 6-year terms
Senators Three 6-year terms
Representatives of the House Three 3-year terms
All other local government officials Three 3-year terms
South Korea President One 5-year term Prime Minister No term limits
Singapore President Unlimited 6 year terms Prime Minister No term limits
Sri Lanka President Two 5-year terms since 2015 Prime Minister No term limits
Syria President Two 7-year terms
Taiwan President Two consecutive 4-year terms since 1994[3][4] Vice President Same as the president
Members of the Legislative Yuan Unlimited 4-year terms since 2008[5]
County, city and township councilors, and village chiefs Unlimited 4-year terms[6]
County magistrates, and city and township mayors Two consecutive 4-year terms[7]
Tajikistan President Two 7-year terms[8]
Thailand Monarch No set terms (Hereditary succession) Prime Minister No term limits
Timor-Leste President Two 5-year terms Prime Minister No term limits
Uzbekistan President Two 5-year terms
Europe[edit]
Country
Head of state
Head of government (if effectively supreme to a separate head of state)
Title
Maximum number of terms
Title
Maximum number of terms
Albania President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Albanian Parliament which has a term of four years
Armenia President Two 5-year terms
Austria President Two 6-year terms. When the current President loses their re-election, they can never again be elected to the Office of Federal President of Austria. Chancellor No directly set terms, however they must maintain the support of the National Council which has a term of five years
Azerbaijan President Unlimited 7-year terms
Belarus President Unlimited 5-year terms
Belgium Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the Chamber of Representatives which has a term of five years
Bosnia and Herzegovina Presidency members Two consecutive 4-year terms
Bulgaria President Two consecutive 5-year terms Prime Minister No directly set terms, however they must maintain the support of the National Assembly which has a term of four years
Croatia President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Sabor which has a term of four years
Cyprus President Two 5-year terms
Czech Republic President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Chamber of Deputies which has a term of four years
Denmark Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the Folketing which has a term of four years
Estonia President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Riigikogu which has a term of four years
European Union President of the European Council Two 2.5 year terms President of the European Commission No directly set terms, however they must maintain the support of the European Parliament which has a term of five years (and also the European Council)
Finland President Two consecutive 6-year terms.[9] Prime Minister No directly set terms, however they must maintain the support of the Finnish Parliament which has a term of four years
France President Two consecutive 5-year terms Prime minister No directly defined terms, however they must maintain the support of the National Assembly which has a term of five years
Georgia President Two 5-year terms Prime Minister of Georgia Unlimited 5-year terms
Germany President Unlimited 5-year terms Chancellor No directly set terms, however they must maintain the support of the Bundestag which has a term of four years
Greece President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Hellenic Parliament which has a term of four years
Hungary President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the National Assembly which has a term of four years
Iceland President Unlimited 4-year terms Prime Minister No directly set terms, however they must maintain the support of the Althing which has a term of four years
Ireland President Two 7-year terms Taoiseach (equivalent of Prime Minister) No directly set terms, however they must maintain the support of the Dáil which has a term of five years
Italy President Unlimited 7-year terms Prime Minister No directly set terms, however they must maintain the support of the Chamber of Deputies which has a term of five years
Latvia President Two 4-year terms Prime Minister No directly set terms, however they must maintain the support of the Saeima which has a term of four years
Lithuania President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Seimas which has a term of four years
Luxemburg Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the Chamber of Deputies which has a term of four years
Macedonia President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Assembly of Macedonia which has a term of four years
Malta President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Maltese Parliament which has a term of five years
Moldova President Two consecutive 4-year terms.[10] Prime Minister No directly set terms, however they must maintain the support of the Moldovan Parliament which has a term of four years
Montenegro President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Montenegrin Parliament which has a term of four years
Netherlands Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the House of Representatives which has a term of less than five years
Norway Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the Storting which has a term of four years
Poland President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Sejm which has a term of four years
Portugal President Two consecutive 5-year terms. A former President of Portugal, however, if they have already served two consecutive terms, can also be re-elected to another unlimited non-consecutive 5-year term, after a minimum of five years out of office since the end of their last term in office. Prime Minister
Presidents of local authorities (concelho and freguesia) No directly set terms, however they must maintain the support of the Assembly of the Republic which has a term of less than four years
Three consecutive 4-year terms
Romania President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Chamber of Deputies, as well as the support of the Senate, both of which have a term of less than four years
Russia President Two consecutive 6-year terms.[11][12][13][14] Prime Minister No directly set terms, however they must maintain the support of the State Duma which has a term of five years
San Marino Captain-Regent Unlimited non-consecutive 6-month terms, but an outgoing Captain Regent of San Marino must wait for a minimum of three years, until they can be elected again into this office.
Serbia President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the National Assembly which has a term of four years
Slovakia President Two consecutive 5-year terms.[15] Prime Minister No directly set terms, however they must maintain the support of the National Council which has a term of four years
Slovenia President Two 5-year terms Prime Minister No directly set terms, however they must maintain the support of the National Assembly which has a term of four years
Spain Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the Congress of Deputies which has a term of four years
Sweden Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the Riksdag which has a term of four years
Switzerland President of the Confederation Unlimited non-consecutive 1-year terms Federal Council Unlimited 4-year terms
Turkey President Two 5-year terms[16] Prime Minister No directly set terms, however they must maintain the support of the Grand National Assembly which has a term of four years
United Kingdom Monarch No set terms (Hereditary succession) Prime Minister No directly set terms, however they must maintain the support of the House of Commons which has a term of five years
Ukraine President Two consecutive 5-year terms Prime Minister No directly set terms, however they must maintain the support of the Verkhovna Rada which has a term of five years
Oceania[edit]
Country
Head of state
Other
Title
Maximum number of terms
Office
Maximum number of terms
Australia Governor-General No term limits, but traditionally serve for one 5-year term. Prime Minister No term limits, 3-year terms
Federated States of Micronesia President Two 4-year terms Vice President Two 4-year terms
Fiji President Two 5-year terms Vice President Two 5-year terms
Kiribati President Three 4-year terms Vice President Three 4-year terms
Marshall Islands President Two 4-year terms
New Zealand Governor-General No term limits, but traditionally serve for one 5-year term. Prime Minister No term limits, 3-year terms
Nauru President Two 3-year terms
Palau President Two 4-year terms Vice President Two 4-year terms
Samoa Chief of State Two 5-year terms since 2007. Before 2007, the Chief of State of Samoa was elected for life.
Solomon Islands Governor-General Two 5-year terms
Vanuatu President One 5-year term
See also[edit]
Term limit
Reelection
References[edit]
Jump up ^ "Nicaragua backs unlimited presidential terms". The Guardian. Retrieved 26 November 2014.
^ Jump up to: a b "Constitution of the People's Republic of China". English.people.com.cn. Article 79: "The term of office of the President and Vice-President of the People's Republic of China is the same as that of the National People's Congress, and they shall serve no more than two consecutive terms".
Jump up ^ Section 6 of Article 2 of the Additional Articles of the Constitution of the Republic of China
Jump up ^ Two consecutive six-year terms from 1947 to 1994 under Article 47 of the Constitution of the Republic of China, but unlimited six-year terms from 1960 to 1991 as superseded by the Temporary Provisions Effective During the Period of Communist Rebellion.
Jump up ^ Article 4 of the Additional Articles of the Constitution of the Republic of China
Jump up ^ Articles 33 and 59 of the Local Government Act
Jump up ^ Articles 55, 56, and 57 of the Local Government Act
Jump up ^ France-Presse, Agence (2016-01-22). "Tajikistan parliament paves way for president to rule for life". The Guardian. ISSN 0261-3077. Retrieved 2016-09-07.
Jump up ^ Constitution of Finland, Chapter 5, Section 54: "The same person may be elected President for no more than two consecutive terms of office".
Jump up ^ Constitution of the Republic of Moldova, Article 80.4: "No person may discharge the duties of the President of the Republic of Moldova unless for two consecutive mandates at the most".
Jump up ^ Constitution of the Russian Federation, Chapter 4, Article 81.3: "One and the same person may not be elected President of the Russian Federation for more than two terms running"
Jump up ^ The Definition of The Russian Federation Supreme Court, issued on 25th of September 2001 (Case N 74-Г01-34): "Thus, the prohibition to be elected President of RSFSR for more than two terms was set by article 121.2 of the RSFSR Constitution (1978, with amendment from 24th may 1991), and the same prohibition is set by article 81 of current Constitution of the Russian Federation for the President of the Russian Federation”. The original excerpt from the Definition: "Так, запрет на избрание одного и того же лица Президентом РСФСР более двух раз был установлен ст. 121.2 Конституции РСФСР 1978 г. (в редакции от 24 мая 1991 г.), а Президента РФ - ст. 81 ныне действующей Конституции РФ". Note: RSFSR stands for "Russian Soviet Federative Socialist Republic".
Jump up ^ The Definition N 134-O of The Russian Federation Constitutional Court, issued on 5th November 1998: "Two consecutive terms <…> constitute the constitutional threshold violation of which the Constitution of the Russian Federation <…> does not allow". The original excerpt from the Definition: "Два срока полномочий подряд <…> составляют конституционный предел, превышения которого Конституция Российской Федерации <…> не допускает".
Jump up ^ The Head of the Russian Federation Constitutional Court V.D. Zorkin issued in 2010 the Commentary on the Constitution of the Russian Federation, where he wrote: "Establishing the two terms limitation of presidential power means the real limitation of this power <…> the two terms limitation for the President of the Russian Federation, periodical (once in six years) State Duma (Parliament Chamber) election, and the legal norm of article 81.3 of Constitution serve as a guaranty for political development of Russia". The original excerpt from the Commentary: "Утверждение принципа ограниченности во времени президентской власти двумя конституционными сроками означает и реальные ограничения этой власти. <…> ограничение занятия должности Президента двумя сроками, периодические выборы (раз в шесть лет) Государственной Думы - палаты парламента Российской Федерации, норма ч. 3 ст. 81 Конституции служит гарантией политического развития России".
Jump up ^ Constitution of the Slovak Republic, Article 103.2: "The same person may be elected President for not more than two consecutive terms".
Jump up ^ "Turks back direct president poll". BBC NEWS. October 21, 2007.
Sources[edit]
CIA World Factbook
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