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Beta-blocker and verapamil — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsBeta-blocker and verapamilGPhC CRA

A patient with angina takes bisoprolol 5 mg daily and presents a new prescription for verapamil MR 240 mg daily. His resting pulse is 54 bpm. What is the most appropriate alternative?

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Correct answer: E — Query the prescription because of bradycardia and heart block risk

Verapamil has rate-limiting effects and combining it with a beta-blocker can cause marked bradycardia, hypotension or heart block. A low resting pulse increases the concern. The pharmacist should query the prescription before supply.

Reference: BNF