Drug interactions
Grapefruit + Verapamil
Severity: Moderate
Grapefruit 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
Grapefruit juice can increase verapamil plasma concentrations, particularly with immediate-release forms. Higher levels may cause hypotension, bradycardia, or AV block, though the effect is variable and generally modest.
What this interaction means in plain words
Grapefruit 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.
Why it happens
Inhibition of intestinal CYP3A4 by furanocoumarins in grapefruit, reducing first-pass metabolism of verapamil.
What to do
Advise patients to avoid regular large intake of grapefruit or its juice. Monitor blood pressure and heart rate if consumption changes.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Grapefruit 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.
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 Grapefruit with Verapamil?
MediHelp rates the interaction as moderate. Grapefruit 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. Grapefruit juice can increase verapamil plasma concentrations, particularly with immediate-release forms. Higher levels may cause hypotension, bradycardia, or AV block, though the effect is variable and generally modest.
How serious is the interaction between Grapefruit 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: Advise patients to avoid regular large intake of grapefruit or its juice. Monitor blood pressure and heart rate if consumption changes.
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.
