Drug interactions
Levobunolol + Verapamil
Severity: Moderate
Levobunolol 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
Levobunolol is an ophthalmic beta-blocker with some systemic absorption. Combined with verapamil it can cause additive bradycardia, AV block and hypotension, and cases of serious conduction disturbance have occurred with oral beta-blocker and verapamil use. Risk is greater with existing conduction disease or heart failure.
What this interaction means in plain words
Levobunolol 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.
Levobunolol belongs to Miscellaneous; Verapamil belongs to Cardiovascular.
Why it happens
Additive negative chronotropic, dromotropic and inotropic effects on the sinus and AV nodes.
What to do
Monitor heart rate, ECG and blood pressure, especially when starting therapy or in patients with conduction abnormalities. Use punctal occlusion to minimize systemic absorption, or choose a non-beta-blocker glaucoma agent in high-risk patients.
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 Levobunolol
- Clonidine + Levobunolol Moderate
- Digoxin + Levobunolol Moderate
- Diltiazem + Levobunolol Moderate
- Fingolimod + Levobunolol Moderate
- Levobunolol + Rivastigmine Moderate
Frequently asked questions
Can I take Levobunolol with Verapamil?
MediHelp rates the interaction as moderate. Levobunolol 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. Levobunolol is an ophthalmic beta-blocker with some systemic absorption. Combined with verapamil it can cause additive bradycardia, AV block and hypotension, and cases of serious conduction disturbance have occurred with oral beta-blocker and verapamil use. Risk is greater with existing conduction disease or heart failure.
How serious is the interaction between Levobunolol 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, ECG and blood pressure, especially when starting therapy or in patients with conduction abnormalities. Use punctal occlusion to minimize systemic absorption, or choose a non-beta-blocker glaucoma agent in high-risk patients.
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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