Verapamil
Pronounced
"ver-APP-uh-mill"
Drug Interactions
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: aliskiren, clonidine, disopyramide, dofetilide, fingolimod, lithium.
Other medications can affect the removal of verapamil from your body, which may affect how verapamil works. Examples include erythromycin, rifamycins (such as rifampin), ritonavir, St. John's wort, among others.
Verapamil can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include asunaprevir, colchicine, elacestrant, fezolinetant, flibanserin, ivabradine, lomitapide, midazolam, triazolam, among others.
Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
Negative Interactions
1- Potential Negative Interaction
Verapamil
Vitamin D
Vitamin D may interfere with the effectiveness of verapamil. People taking verapamil should ask their doctor before using vitamin D-containing supplements.
Vitamin DVerapamil- Threlkeld DS, ed. Diuretics and Cardiovasculars, Calcium Channel Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1992, 150-b.
Supportive Interactions
1- Reduce Side Effects
Verapamil
Fiber
Constipation is a common side effect of verapamil treatment. Increasing fluid and fiber intake can ease constipation.
FiberVerapamil- Threlkeld DS, ed. Diuretics and Cardiovasculars, Calcium Channel Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Nov 1992, 150-b.
Explanation Required
3- Needs Explanation
Verapamil
Grapefruit
Grapefruit juice may increase verapamil blood levels. The importance of this interaction regarding verapamil effectiveness and side effects is unknown. Until more is known, it makes sense for people taking this drug to either avoid drinking grapefruit juice entirely or drink grapefruit juice only under the careful monitoring and supervision of the prescribing doctor. In theory, this last possibility might allow for a decrease in drug dose, but it could be dangerous in the absence of diligent monitoring. The same effects might be seen from eating grapefruit as from drinking its juice.
GrapefruitVerapamil- Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 274-5.
- Needs Explanation
Verapamil
Pleurisy Root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as calcium channel blockers.
Pleurisy RootVerapamil- Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213-4.
- Needs Explanation
Verapamil
Pomegranate
Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice. The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with verapamil in the same way that grapefruit juice does.
PomegranateVerapamil- Sorokin AV, Duncan B, Panetta R, Thompson PD. Rhabdomyolysis associated with pomegranate juice consumption. Am J Cardiol 2006;98:705-6.
- Summers KM. Potential drug-food interactions with pomegranate juice. Ann Pharmacother 2006;40:1472-3.
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