Drug interactions
Deflazacort + Verapamil
Severity: Major
Deflazacort 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
Deflazacort's active metabolite is cleared via CYP3A4, and verapamil, a moderate CYP3A4 and P-glycoprotein inhibitor, increases exposure to it. This raises the risk of corticosteroid adverse effects such as Cushingoid features, infection and adrenal suppression. Labeling advises dose reduction with moderate CYP3A4 inhibitors.
What this interaction means in plain words
Deflazacort 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.
Deflazacort belongs to Miscellaneous; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4 metabolism and P-glycoprotein efflux, increasing exposure to deflazacort's active metabolite.
What to do
Reduce the deflazacort dose to one-third of the recommended dose while verapamil is co-administered, as per labeling. Monitor for signs of glucocorticoid excess.
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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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 Deflazacort
- Adenovirus types 4 and 7 live + Deflazacort Contraindicated
- Bcg vaccine live + Deflazacort Contraindicated
- Deflazacort + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Deflazacort + Measles mumps and rubella vaccine Contraindicated
- Deflazacort + Measles mumps and rubella vaccine live Contraindicated
- Deflazacort + Measles mumps rubella and varicella vaccine live Contraindicated
Frequently asked questions
Can I take Deflazacort with Verapamil?
MediHelp rates the interaction as major. Deflazacort 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. Deflazacort's active metabolite is cleared via CYP3A4, and verapamil, a moderate CYP3A4 and P-glycoprotein inhibitor, increases exposure to it. This raises the risk of corticosteroid adverse effects such as Cushingoid features, infection and adrenal suppression. Labeling advises dose reduction with moderate CYP3A4 inhibitors.
How serious is the interaction between Deflazacort 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: Reduce the deflazacort dose to one-third of the recommended dose while verapamil is co-administered, as per labeling. Monitor for signs of glucocorticoid excess.
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.
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