Drug interactions
Nebivolol + Verapamil
Severity: Major
Nebivolol 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 depresses sinus and AV node function and myocardial contractility, and a beta-blocker adds to these effects. The combination can cause severe bradycardia, AV block, hypotension, and acute heart failure.
What this interaction means in plain words
Nebivolol 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.
Nebivolol belongs to Cardiovascular; Verapamil belongs to Cardiovascular.
Why it happens
Additive negative chronotropic, dromotropic, and inotropic effects from calcium channel blockade and beta-blockade; verapamil may also modestly raise beta-blocker levels.
What to do
Avoid the combination when possible, especially in left ventricular dysfunction or conduction disease. If it is used, monitor ECG, heart rate, and blood pressure closely and start with low doses.
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 Nebivolol
- Acebutolol + Nebivolol Major
- Aldesleukin + Nebivolol Major
- Amiodarone + Nebivolol Major
- Atenolol-chlorthalidone + Nebivolol Major
- Atenolol + Nebivolol Major
- Betaxolol + Nebivolol 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 Nebivolol with Verapamil?
MediHelp rates the interaction as major. Nebivolol 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 depresses sinus and AV node function and myocardial contractility, and a beta-blocker adds to these effects. The combination can cause severe bradycardia, AV block, hypotension, and acute heart failure.
How serious is the interaction between Nebivolol 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: Avoid the combination when possible, especially in left ventricular dysfunction or conduction disease. If it is used, monitor ECG, heart rate, and blood pressure closely and start with low doses.
What other medicines interact with Nebivolol?
MediHelp also lists interactions of Nebivolol with, for example, Acebutolol, Aldesleukin, Amiodarone. The full list is on the Nebivolol page.
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