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Verapamil and beta-blocker — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsVerapamil and beta-blockerGPhC CRA

A patient taking bisoprolol for rate control is prescribed verapamil for migraine prophylaxis. Their pulse in the pharmacy is 54 bpm. What is the most important interaction to flag?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Bradycardia and heart block risk

Verapamil combined with a beta-blocker increases the risk of significant bradycardia and AV block. The low pulse makes this interaction clinically important before supply. In this scenario, the correct option is bradycardia and heart block risk. The other options are plausible but do not address the key clinical, legal or safety issue as directly. This aligns with UK pharmacy practice guidance cited in the reference field.

Reference: BNF; Stockley's Drug Interactions