Drug interactions
Fosaprepitant + Verapamil
Severity: Moderate
Fosaprepitant 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
Fosaprepitant is converted to aprepitant, a moderate CYP3A4 inhibitor, which may increase verapamil concentrations after a single dose. Verapamil, a moderate CYP3A4 inhibitor, may also raise aprepitant levels. The effect is usually modest with single-dose fosaprepitant.
What this interaction means in plain words
Fosaprepitant 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.
Fosaprepitant belongs to Gastrointestinal Tract; Verapamil belongs to Cardiovascular.
Why it happens
Aprepitant inhibits CYP3A4, reducing verapamil clearance; verapamil reciprocally inhibits CYP3A4 metabolism of aprepitant.
What to do
Monitor blood pressure, heart rate and PR interval during and for several days after fosaprepitant administration. Reduce the verapamil dose if hypotension or bradycardia develops.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Other interactions of Fosaprepitant
- Flibanserin + Fosaprepitant Contraindicated
- Fosaprepitant + Pimozide Contraindicated
- Alprazolam + Fosaprepitant Moderate
- Amiodarone + Fosaprepitant Moderate
- Amobarbital + Fosaprepitant Moderate
- Apalutamide + Fosaprepitant Moderate
Frequently asked questions
Can I take Fosaprepitant with Verapamil?
MediHelp rates the interaction as moderate. Fosaprepitant 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. Fosaprepitant is converted to aprepitant, a moderate CYP3A4 inhibitor, which may increase verapamil concentrations after a single dose. Verapamil, a moderate CYP3A4 inhibitor, may also raise aprepitant levels. The effect is usually modest with single-dose fosaprepitant.
How serious is the interaction between Fosaprepitant 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 blood pressure, heart rate and PR interval during and for several days after fosaprepitant administration. Reduce the verapamil dose if hypotension or bradycardia develops.
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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