Drug interactions
Nisoldipine + Verapamil
Severity: Major
Nisoldipine 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 inhibits CYP3A4 and can greatly increase nisoldipine exposure. The combination also adds vasodilatory effects, with risk of hypotension, edema and reflex tachycardia.
What this interaction means in plain words
Nisoldipine 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.
Nisoldipine belongs to Cardiovascular; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4 metabolism of nisoldipine, with additive calcium channel blockade.
What to do
Avoid the combination where possible, as two calcium channel blockers rarely add benefit. If used, start nisoldipine at a low dose and monitor blood pressure closely.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Other interactions of Nisoldipine
- Itraconazole + Nisoldipine Contraindicated
- Ketoconazole + Nisoldipine Contraindicated
- Apalutamide + Nisoldipine Major
- Carbamazepine + Nisoldipine Major
- Chloramphenicol + Nisoldipine Major
- Clarithromycin + Nisoldipine Major
Frequently asked questions
Can I take Nisoldipine with Verapamil?
MediHelp rates the interaction as major. Nisoldipine 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 inhibits CYP3A4 and can greatly increase nisoldipine exposure. The combination also adds vasodilatory effects, with risk of hypotension, edema and reflex tachycardia.
How serious is the interaction between Nisoldipine 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 where possible, as two calcium channel blockers rarely add benefit. If used, start nisoldipine at a low dose and monitor blood pressure closely.
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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