Drug interactions
Procainamide + Verapamil
Severity: Moderate
Procainamide 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
Both drugs can affect cardiac conduction, and the combination may add to hypotension, bradycardia, AV block or QT/QRS prolongation. Competition for renal tubular secretion has also been proposed but is a minor factor.
What this interaction means in plain words
Procainamide 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
Additive negative effects on cardiac conduction and contractility, with possible competition for renal tubular secretion.
What to do
Monitor ECG, heart rate and blood pressure, and check procainamide and NAPA levels if toxicity is suspected. Reduce doses if conduction abnormalities develop.
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
Frequently asked questions
Can I take Procainamide with Verapamil?
MediHelp rates the interaction as moderate. Procainamide 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. Both drugs can affect cardiac conduction, and the combination may add to hypotension, bradycardia, AV block or QT/QRS prolongation. Competition for renal tubular secretion has also been proposed but is a minor factor.
How serious is the interaction between Procainamide 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 ECG, heart rate and blood pressure, and check procainamide and NAPA levels if toxicity is suspected. Reduce doses if conduction abnormalities develop.
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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