Drug interactions
Dabigatran etexilate + Verapamil
Severity: Major
Dabigatran etexilate and Verapamil: major 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
Verapamil inhibits P-glycoprotein and increases dabigatran exposure, raising bleeding risk. The effect is greatest with immediate-release verapamil taken at the same time as dabigatran.
What this interaction means in plain words
Dabigatran etexilate 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.
Dabigatran etexilate belongs to Cardiovascular; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits intestinal P-glycoprotein efflux, increasing dabigatran etexilate absorption.
What to do
In atrial fibrillation, reduce the dabigatran dose per labeling when used with verapamil and give dabigatran at least 2 hours before immediate-release verapamil. Avoid in severe renal impairment and monitor for bleeding.
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?
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Other interactions of Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate 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 Dabigatran etexilate with Verapamil?
MediHelp rates the interaction as major. Dabigatran etexilate 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. Verapamil inhibits P-glycoprotein and increases dabigatran exposure, raising bleeding risk. The effect is greatest with immediate-release verapamil taken at the same time as dabigatran.
How serious is the interaction between Dabigatran etexilate 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: In atrial fibrillation, reduce the dabigatran dose per labeling when used with verapamil and give dabigatran at least 2 hours before immediate-release verapamil. Avoid in severe renal impairment and monitor for bleeding.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate page.
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