Drug interactions
amiodarone + verapamil
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Additive AV-nodal suppression and hypotension; amiodarone may increase verapamil exposure (CYP3A4/P-gp). Risk of bradycardia, AV block, and hemodynamic compromise.
Mechanism of action
Pharmacodynamic additive negative chronotropy/dromotropy; amiodarone inhibits CYP3A4/P-gp → ↑ verapamil; verapamil inhibits P-gp → possible ↑ amiodarone.
Clinical management
Avoid in significant conduction disease or decompensated HF. If coadministered, use lower initial doses, titrate cautiously, and monitor HR/BP and ECG; hold or reduce dose if bradycardia or AV block occurs.
Drug reference
References
- Amiodarone (amiodarone HCl) Prescribing Information — FDA Label
- Verapamil HCl Prescribing Information — FDA Label
- Amiodarone–Verapamil drug interaction monograph — Lexicomp
Frequently asked questions
Can I take amiodarone with verapamil?
The interaction is rated: Major. Additive AV-nodal suppression and hypotension; amiodarone may increase verapamil exposure (CYP3A4/P-gp). Risk of bradycardia, AV block, and hemodynamic compromise.
How serious is the interaction between amiodarone and verapamil?
The interaction is rated: Major. Evidence level: High.
How is the interaction between amiodarone and verapamil managed?
Avoid in significant conduction disease or decompensated HF. If coadministered, use lower initial doses, titrate cautiously, and monitor HR/BP and ECG; hold or reduce dose if bradycardia or AV block occurs.
Why do amiodarone and verapamil interact?
Pharmacodynamic additive negative chronotropy/dromotropy; amiodarone inhibits CYP3A4/P-gp → ↑ verapamil; verapamil inhibits P-gp → possible ↑ amiodarone.
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