Drug interactions
Atazanavir + Verapamil
Severity: Major
Atazanavir and Verapamil: major interaction.
Last updated Sources: US FDA label
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.
Summary
Atazanavir inhibits CYP3A4 and can raise verapamil levels, while verapamil may also modestly raise atazanavir levels. Both drugs prolong AV conduction, so the combination increases the risk of bradycardia and AV block.
What this interaction means in plain words
Atazanavir and Verapamil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Verapamil belongs to Cardiovascular.
Why it happens
Mutual CYP3A4 inhibition combined with additive PR-interval prolongation.
What to do
Monitor ECG for PR prolongation and heart rate, and reduce the verapamil dose if conduction abnormalities occur; avoid in patients with existing AV block.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Atazanavir and Verapamil, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Verapamil?
MediHelp rates the interaction as major. Atazanavir and Verapamil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir inhibits CYP3A4 and can raise verapamil levels, while verapamil may also modestly raise atazanavir levels. Both drugs prolong AV conduction, so the combination increases the risk of bradycardia and AV block.
How serious is the interaction between Atazanavir and Verapamil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG for PR prolongation and heart rate, and reduce the verapamil dose if conduction abnormalities occur; avoid in patients with existing AV block.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
