Drug interactions
Cimetidine + Verapamil
Severity: Moderate
Cimetidine and Verapamil: moderate interaction.
Last updated
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
Cimetidine can increase verapamil plasma concentrations and enhance its effects. This may cause excessive hypotension, bradycardia or AV block, especially in older patients or those with conduction disease.
What this interaction means in plain words
Cimetidine and Verapamil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cimetidine belongs to Gastrointestinal Tract; Verapamil belongs to Cardiovascular.
Why it happens
Cimetidine inhibits hepatic CYP3A4 and other CYP enzymes, reducing verapamil clearance.
What to do
Monitor heart rate, blood pressure and ECG when starting or stopping cimetidine, and lower the verapamil dose if needed. Prefer famotidine or another H2 blocker lacking CYP inhibition.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
Other interactions of Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Frequently asked questions
Can I take Cimetidine with Verapamil?
MediHelp rates the interaction as moderate. Cimetidine and Verapamil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cimetidine can increase verapamil plasma concentrations and enhance its effects. This may cause excessive hypotension, bradycardia or AV block, especially in older patients or those with conduction disease.
How serious is the interaction between Cimetidine and Verapamil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, blood pressure and ECG when starting or stopping cimetidine, and lower the verapamil dose if needed. Prefer famotidine or another H2 blocker lacking CYP inhibition.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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