Drug interactions
Riociguat + Verapamil
Severity: Moderate
Riociguat 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
Riociguat is cleared through several CYP enzymes including CYP3A, and verapamil inhibits CYP3A4 moderately. Higher riociguat levels and the additive vasodilator effect of verapamil can produce symptomatic hypotension.
What this interaction means in plain words
Riociguat 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.
Riociguat belongs to Cardiovascular; Verapamil belongs to Cardiovascular.
Why it happens
Pharmacokinetic inhibition of CYP3A4 plus additive vasodilatory effects.
What to do
Monitor blood pressure and symptoms of hypotension when starting or changing either drug. Reduce the riociguat dose if hypotension develops.
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 Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
Frequently asked questions
Can I take Riociguat with Verapamil?
MediHelp rates the interaction as moderate. Riociguat 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. Riociguat is cleared through several CYP enzymes including CYP3A, and verapamil inhibits CYP3A4 moderately. Higher riociguat levels and the additive vasodilator effect of verapamil can produce symptomatic hypotension.
How serious is the interaction between Riociguat 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 blood pressure and symptoms of hypotension when starting or changing either drug. Reduce the riociguat dose if hypotension develops.
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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