Verapamil/diltiazem + beta blocker — bradycardia/AV block

Interaction at a glance

• Bradycardia, heart block, hypotension
• Avoid unless clear indication + monitoring

Mechanism

• Both slow AV-node conduction
• non-DHP CCB slows conduction
• beta blocker slows rate + AV node
• Verapamil is generally more depressant

Clinical consequence

• Bradycardia, heart block, hypotension

Monitoring

• Avoid unless clear indication + monitoring

Self-check

• What is the main clinical risk of Verapamil/diltiazem + beta blocker?
  Bradycardia, heart block, hypotension.
• What is the preferred management of Verapamil/diltiazem + beta blocker?
  Avoid unless clear indication + monitoring.
• Should Verapamil/diltiazem + beta blocker generally be combined?
  No—avoid the combination when feasible.

Drugs in this interaction (16)

All interaction examples · Open the interactive console ↗