Drug interactions
Timolol + Verapamil
Severity: Major
Timolol 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 and beta-blockers both depress sinus and AV nodal function and myocardial contractility. Together they can cause severe bradycardia, AV block, hypotension and heart failure, and this has also been reported with timolol eye drops.
What this interaction means in plain words
Timolol 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.
Timolol belongs to Cardiovascular; Verapamil belongs to Cardiovascular.
Why it happens
Additive negative chronotropic, dromotropic and inotropic effects from calcium channel blockade and beta-blockade.
What to do
Avoid in patients with conduction disease or reduced ventricular function. Otherwise monitor ECG, heart rate and 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Timolol and Verapamil, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Timolol
- Acebutolol + Timolol Major
- Albuterol + Timolol Major
- Aldesleukin + Timolol Major
- Amifostine + Timolol Major
- Amiodarone + Timolol Major
- Arformoterol + Timolol 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 Timolol with Verapamil?
MediHelp rates the interaction as major. Timolol 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 and beta-blockers both depress sinus and AV nodal function and myocardial contractility. Together they can cause severe bradycardia, AV block, hypotension and heart failure, and this has also been reported with timolol eye drops.
How serious is the interaction between Timolol 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 in patients with conduction disease or reduced ventricular function. Otherwise monitor ECG, heart rate and blood pressure closely.
What other medicines interact with Timolol?
MediHelp also lists interactions of Timolol with, for example, Acebutolol, Albuterol, Aldesleukin. The full list is on the Timolol page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
