Compatibility «Verapamil» and «Bisoprolol+Amlodipine»

• Interactions Verapamil with Bisoprolol+Amlodipine

  • Dangerous interactions
    • ⓘ With the combined use of BMCC with lithium preparations (no data are available for amlodipine), their neurotoxicity may increase (nausea, vomiting, diarrhea, ataxia, tremor, tinnitus).
    • ⓘ Beta-blockers, class IA antiarrhythmics, cardiac glycosides, inhalation anesthetics, radiopaque substances potentiate (mutually) depressing effects on the automatism of the sinoatrial node, AV conduction and myocardial contractility.
    • ⓘ Simultaneous intravenous administration of verapamil and beta-blockers led to serious side effects (severe bradycardia), especially in patients with cardiomyopathy, heart failure or recent myocardial infarction.
    • ⓘ Verapamil (C08DA01) + Beta-blockers (C07) => The risk of angina pectoris, AU block, hypotension, and heart failure increases. During treatment with verapamil, p-adrenergic receptor blockers should not be administered intravenously. There is a pronounced negative chronotropic (up to cardiac arrest), inotropic (up to the development of acute left ventricular failure) and dromotropic (up to complete AV block) effect. The probability increases dramatically with initial cardiac dysfunction and with intravenous administration of drugs against the background of a course of beta-blockers. (A dangerous combination, although its use may be justified in the treatment of arrhythmias, severe forms of angina pectoris occurring against a background of pronounced tachycardia not associated with congestive heart failure. Monitoring of contractility, conduction, heart rate. Intravenous administration of beta-blockers against the background of treatment with verapamil or vice versa is contraindicated).
    • ⓘ beta-blockers (C07) + Verapamil, reserpine, phenigidine => Increased existing heart failure, bradycardia, impaired conduction.
    • ⓘ In animal experiments, cases of fatal ventricular fibrillation and cardiovascular insufficiency associated with hyperkalemia were observed after administration of verapamil and dantrolene (intravenously).
  • Negative interactions
    • ⓘ Although no negative inotropic effect was usually observed in the study of amlodipine, nevertheless, some BMCC may enhance the severity of the negative inotropic effect of antiarrhythmic agents that cause prolongation of the QT interval (for example, amiodarone and quinidine).
    • ⓘ BMCC of the verapamil type and, to a lesser extent, diltiazem, when used concomitantly with bisoprolol, can lead to a decrease in myocardial contractility, a marked decrease in blood pressure and impaired AV conduction.
    • ⓘ In particular, intravenous administration of verapamil to patients taking beta-blockers can lead to severe arterial hypotension and AV blockade.
    • ⓘ BMCC, dihydropyridine derivatives (for example, nifedipine), when used concomitantly with bisoprolol, may increase the risk of arterial hypotension.
    • ⓘ The probability of violations of automatism, conduction and contractility of the heart increases (mutually) against the background of amiodarone, diltiazem, verapamil, quinidine preparations, cardiac glycosides, reserpine, alpha-methyldopha.
    • ⓘ Blockers of 'slow' calcium channels (BMCC) such as verapamil and to a lesser extent diltiazem, when used simultaneously with bisoprolol, can lead to a decrease in myocardial contractility and impaired AV conduction.
    • ⓘ In particular, intravenous administration of verapamil to patients taking beta‑blockers can lead to severe arterial hypotension and AV blockage.
    • ⓘ Amlodipine and Verapamil belong to the same pharmaceutical group: Calcium Channel Blockers.
  • No interactions
    • ⓘ Unlike other BMCC, no clinically significant interaction of amlodipine (generation III BMCC) was found when combined with NSAIDs, PM and indomethacin.
  • Positive interactions
    • ⓘ It is possible to enhance the antianginal and hypotensive effects of BMCC when combined with thiazide and loop diuretics, ACE inhibitors, beta-blockers and nitrates, as well as to enhance their hypotensive effect when combined with alpha₁-blockers, neuroleptics.
    • ⓘ Increases plasma concentrations of BMCC, PM and amlodipine.
  • Unclear interactions
    • ⓘ Calcium supplements can reduce the effect of BMCC.
    • ⓘ Beta blockers.
    • ⓘ Beta-blockers should be prescribed a few hours before or a few hours after the use of verapamil.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,034,295 possible combinations of drugs and their components were found 412,570 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-03-26

Category - medicine