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Digoxin and verapamil — GPhC CRA MCQ

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HardDrug InteractionsDigoxin and verapamilGPhC CRA

A 78-year-old woman takes digoxin for atrial fibrillation and receives a new prescription for verapamil modified-release. She reports nausea and her pulse is 50 beats/minute. What is the most important interaction to flag?

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Correct answer: D — Verapamil may increase digoxin levels and bradycardia risk

Verapamil can increase digoxin concentrations and also slows atrioventricular conduction. Nausea and bradycardia are concerning for digoxin toxicity or excessive rate control. The combination needs prescriber review and possible monitoring. Acid suppression is not the relevant mechanism.

Reference: BNF