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Verapamil and beta-blocker — GPhC CRA MCQ

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HardDrug InteractionsVerapamil and beta-blockerGPhC CRA

A patient taking bisoprolol 5 mg daily is prescribed verapamil modified-release for angina. His resting pulse is 56 beats per minute. What is the most important interaction to flag?

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Correct answer: C — Increased risk of bradycardia, heart block and hypotension

Verapamil and beta-blockers both reduce heart rate and atrioventricular conduction. The combination can cause bradycardia, heart block and hypotension, especially if baseline pulse is low. The pharmacist should query the combination with the prescriber. This is a clinically important cardiovascular interaction.

Reference: BNF