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Beta-blocker and verapamil — GPhC CRA MCQ

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HardDrug InteractionsBeta-blocker and verapamilGPhC CRA

A 71-year-old man is newly prescribed bisoprolol 1.25mg daily for heart failure. His pulse is 58bpm, BP 122/68mmHg and he reports mild ankle swelling but no dizziness. He also takes verapamil MR 240mg daily for angina. What is the most appropriate action?

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Correct answer: BQuery the combination because verapamil with beta-blocker increases bradycardia and heart block risk

Beta-blockers combined with verapamil can cause significant bradycardia, hypotension and AV block. The patient's baseline pulse is already relatively low, making the risk clinically important. The low starting dose of bisoprolol does not remove the need to query the combination. Lipid monitoring is not relevant to this immediate safety issue.

Reference: BNF