Verapamil/diltiazem + beta blocker — bradycardia/AV block
- Both slow AV-node conduction
- non-DHP CCB slows conduction
- beta blocker slows rate + AV node
- Bradycardia, heart block, hypotension
- Verapamil is generally more depressant
- Avoid unless clear indication + monitoring
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
- Key risk with Verapamil/diltiazem + beta blocker?
Bradycardia, heart block, hypotension. - How should Verapamil/diltiazem + beta blocker be managed?
Avoid unless clear indication + monitoring. - What shared conduction effect underlies verapamil/diltiazem plus beta-blocker risk?
Both slow AV-node conduction.
Drugs in this interaction (16)
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