Verapamil Interactions

Cardiovascular collapse and marked hyperkalemia reported with IV dantrolene and calcium channel blockers; contraindicated during malignant hyperthermia crisis management.

Source: NLP:dantrolene

Do not administer disopyramide within 48 hours before or 24 hours after verapamil due to potential serious interactions.

Source: NLP:disopyramide phosphate

Verapamil increases dofetilide peak plasma levels by 42% and is associated with higher occurrence of Torsade de Pointes. Concomitant use is contraindicated.

Source: NLP:dofetilide

In patients with depressed myocardial function, concomitant use can lead to fatal cardiac arrests.

Source: NLP:esmolol hydrochloride

Little experience with coadministration. Should not be administered concurrently unless benefits outweigh risks due to negative inotropic properties.

Source: NLP:flecainide acetate

Coadministration is contraindicated. Non-dihydropyridine calcium-channel antagonist that can increase risk of bradycardia or hypotension.

Source: NLP:labetalol hydrochloride

Rarely associated with ventricular fibrillation when combined with adenosine injection. Use with caution due to potential additive depressant effects on SA and AV nodes.

Source: NLP:adenosine

Negative chronotrope. Potentiates electrophysiologic and hemodynamic effects resulting in bradycardia, sinus arrest, and AV block.

Source: NLP:amiodarone hydrochloride

Calcium antagonist that depresses myocardium and inhibits AV conduction; use with care when combined with bisoprolol fumarate.

Source: NLP:bisoprolol fumarate

Verapamil increased buspirone AUC and Cmax 3.4-fold; adverse events attributable to buspirone may be more likely during concomitant administration.

Source: NLP:buspirone hydrochloride

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with clonidine and verapamil concomitantly.

Source: NLP:clonidine

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with concomitant use of clonidine and verapamil.

Source: NLP:clonidine hydrochloride

Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported with concurrent use of clonidine and verapamil.

Source: NLP:clonidine transdermal system

Toxicities reported when colchicine is administered with verapamil, a CYP3A4 inhibitor. Serious and life-threatening toxicity potential.

Source: NLP:colchicine

Postmarketing cases of serotonin syndrome reported during combined use; careful observation advised.

Source: NLP:cyclobenzaprine

Serotonin syndrome reported during combined use.

Source: NLP:cyclobenzaprine hydrochloride

Cardiovascular collapse, ventricular fibrillation, and marked hyperkalemia reported with concurrent use. Combination not recommended during malignant hyperthermia management.

Source: NLP:dantrolene sodium

Moderate or strong CYP3A4 inhibitor; reduce EMFLAZA dose to one third of recommended dosage when used concomitantly.

Source: NLP:deflazacort

Increases digoxin serum concentration by 50-75%. Requires monitoring and dose reduction of 30-50%.

Source: NLP:digoxin

CYP3A4 inhibitor that increases doxorubicin concentration and clinical effect. Clinically significant interaction reported.

Source: NLP:doxorubicin hydrochloride

Hypotension, bradyarrhythmias, and lactic acidosis observed with concomitant use. CYP3A4-metabolized calcium channel blocker.

Source: NLP:erythromycin

Concurrent verapamil use has been associated with hypotension, bradyarrhythmias, and lactic acidosis.

Source: NLP:erythromycin ethylsuccinate

CYP3A4 inhibitor may affect everolimus concentrations; dose adjustment consideration recommended.

Source: NLP:everolimus

Do not exceed 10 mg/10 mg ezetimibe and simvastatin tablets daily due to increased myopathy risk.

Source: NLP:ezetimibe and simvastatin

Heart rate-slowing calcium channel blocker. Concomitant use during fingolimod initiation may result in severe bradycardia or heart block.

Source: NLP:fingolimod

Heart rate-slowing calcium channel blocker. Concomitant use during fingolimod initiation may cause severe bradycardia or heart block. Consider switching.

Source: NLP:fingolimod hcl

Increases risk of myopathy/rhabdomyolysis, particularly with higher doses of lovastatin.

Source: NLP:lovastatin

Calcium channel blocker slows atrioventricular conduction and decreases heart rate; concomitant use with metoprolol increases bradycardia risk.

Source: NLP:metoprolol succinate

Calcium channel blocker that slows atrioventricular conduction and decreases heart rate; concomitant use with metoprolol increases risk of bradycardia.

Source: NLP:metoprolol succinate er tablets

Concomitant use increases risk of bradycardia due to additive negative chronotropic effects.

Source: NLP:metoprolol tartrate

Calcium channel blocker that slows atrioventricular conduction; concomitant use with metoprolol can increase risk of bradycardia.

Source: NLP:metoprolol tartrate and hydrochlorothiazide

Calcium channel blocker that may cause excessive reductions in heart rate, blood pressure, and cardiac contractility.

Source: NLP:nebivolol

Calcium channel blocker may cause excessive reductions in heart rate, blood pressure, and cardiac contractility.

Source: NLP:nebivolol hydrochloride

Concurrent use with beta-blockers reported to cause significant bradycardia, heart failure, and cardiovascular collapse.

Source: NLP:propranolol hydrochloride

Verapamil significantly reduces hepatic clearance of quinidine with corresponding increases in serum levels and half-life.

Source: NLP:quinidine gluconate

In animals, impairment of atrioventricular conduction has been observed when verapamil and sevoflurane are administered concomitantly.

Source: NLP:sevoflurane

Calcium channel blocker that increases risk of myopathy and rhabdomyolysis. Do not exceed simvastatin 10 mg daily.

Source: NLP:simvastatin

Calcium channel blocker; concomitant use increases risk of bradycardia and hypotension.

Source: NLP:sotalol hydrochloride

P-gp inhibitor that increases talazoparib concentrations; avoid coadministration or reduce talazoparib dose and monitor for increased adverse reactions.

Source: NLP:talazoparib

CYP1A2 inhibitor; concomitant use should be avoided due to potential for hypotension, bradycardia, or excessive drowsiness.

Source: NLP:tizanidine

Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate cautiously.

Source: NLP:tizanidine hydrochloride

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Source: NLP:tizanidne hydrochloride

Calcium antagonist that may depress myocardium and inhibit AV conduction. Use with caution when combined with bisoprolol.

Source: NLP:bisoprolol fumarate and hydrochlorothiazide

CYP3A4 inhibitor that increases carbamazepine plasma levels. Close monitoring of carbamazepine levels and dosage adjustment may be required.

Source: NLP:carbamazepine

Calcium channel blocker may affect ECG and/or blood pressure when used with carvedilol.

Source: NLP:carvedilol

Calcium channel blocker that may affect ECG and/or blood pressure when used with carvedilol.

Source: NLP:carvedilol phosphate

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Source: NLP:cyclosporine

Moderate to strong CYP3A4 inhibitor can increase plasma concentrations of estrogen or progestin or both.

Source: NLP:drospirenone and ethinyl estradiol

Moderate or strong CYP3A4 inhibitor that can increase plasma concentrations of estrogen or progestin or both.

Source: NLP:drospirenone, ethinyl estradiol and levomefolate calcium and levomefolate calcium

Moderate to strong CYP3A4 inhibitor that can increase plasma concentrations of estrogen or progestin.

Source: NLP:drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium

Moderate CYP3A inhibitor; do not exceed 25 mg once daily in post-MI HFrEF patients; initiate at 25 mg once daily in hypertension patients.

Source: NLP:eplerenone

Moderate CYP3A4 inhibitor. No dosing adjustments recommended in the presence of this drug.

Source: NLP:fesoterodine fumarate

Moderate CYP3A4 inhibitor that increases ivabradine plasma concentrations. Avoid concomitant use.

Source: NLP:ivabradine

Care should be taken when using labetalol concomitantly with verapamil, a calcium antagonist.

Source: NLP:labetalol

Moderate CYP3A4 inhibitor that increases lurasidone exposure; dose should be reduced to half.

Source: NLP:lurasidone hydrochloride

Concomitant use increases risk of bradycardia due to combined negative chronotropic effects.

Source: NLP:metoprolol

Inhibits P450-3A4 enzyme system, increasing midazolam half-life from 5 to 7 hours and prolonging sedation.

Source: NLP:midazolam

Inhibits P450-3A4 enzyme system, increasing midazolam half-life from 5 to 7 hours, resulting in prolonged sedation.

Source: NLP:midazolam hydrochloride

P-glycoprotein inhibitor increasing plasma naldemedine concentrations; monitor for adverse reactions.

Source: NLP:naldemedine

Concomitant use can potentiate electrophysiologic and hemodynamic effects, resulting in bradycardia, sinus arrest, and AV block.

Source: NLP:nexterone (amiodarone hci)

CYP3A inhibitor that increases nifedipine exposure during concomitant therapy. Blood pressure should be monitored and dose reduction of nifedipine considered.

Source: NLP:nifedipine

Moderate CYP3A4 inhibitor and calcium channel blocker that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

Source: NLP:nimodipine

Significantly reduces hepatic clearance of quinidine with corresponding increases in serum levels and half-life.

Source: NLP:quinidine sulfate tablet

CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.

Source: NLP:ranolazine

Weak/moderate CYP3A4/P-gp inhibitor that may increase sirolimus concentrations; verapamil concentrations may also increase. Monitor and adjust dosage as needed.

Source: NLP:sirolimus

Moderate CYP3A4 inhibitor that may increase silodosin concentration. Monitor patients for adverse events.

Source: NLP:silodosin

Moderate CYP3A inhibitor; recommended suvorexant dose is 5 mg, may increase to 10 mg if needed.

Source: NLP:suvorexant

Mild or moderate CYP3A inhibitor calcium channel blocker that may affect tacrolimus concentrations. Monitor tacrolimus whole blood trough concentrations.

Source: NLP:tacrolimus

Verapamil increases terazosin AUC by 11-24%, Cmax by 25%, and Cmin by 32% after 3 weeks of concomitant use, with decreased Tmax from 1.3 to 0.8 hours.

Source: NLP:terazosin

Data from clinical studies of similar benzodiazepines suggest possible drug interaction with triazolam. Caution recommended.

Source: NLP:triazolam

P-gp inhibitor that does not require dosage adjustment of dabigatran etexilate.

Source: NLP:dabigatran etexilate

Moderate CYP3A4 inhibitor. No dosing adjustments recommended with darifenacin.

Source: NLP:darifenacin

Moderate CYP3A4 inhibitor; no dosing adjustments recommended.

Source: NLP:darifenacin hydrobromide

Decreases dutasteride clearance and increases dutasteride exposure, but this change is not clinically significant and no dose adjustment is recommended.

Source: NLP:dutasteride

CYP3A inhibitor not expected to have significant effect on prasugrel active metabolite pharmacokinetics.

Source: NLP:prasugrel