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Digoxin and verapamil — GPhC CRA MCQ

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HardDrug InteractionsDigoxin and verapamilGPhC CRA

A 79-year-old woman taking digoxin 125micrograms daily for AF rate control is prescribed verapamil modified-release 120mg daily. She reports nausea and yellow-green visual disturbance. Her eGFR is 41mL/min/1.73m2 and pulse is 52/min. What is the most important interaction to flag?

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Correct answer: B — Verapamil may increase digoxin concentration and bradycardia risk

Verapamil can increase digoxin concentrations and both medicines can slow heart rate. Symptoms such as nausea, visual disturbance and bradycardia suggest possible digoxin toxicity. Renal impairment further increases risk. Urgent prescriber review and digoxin level assessment are needed.

Reference: BNF Digoxin interactions; BNF Verapamil