Cimetidine (Tagamet)
Cimetidine may increase the level of
verapamil in your blood, increasing your risk of verapamil side effects (although drug interaction studies have shown mixed results). Your healthcare provider may need to adjust your verapamil dose or may suggest an alternative to cimetidine.
Cyclosporine (Gengraf, Neoral, Sandimmune)
Verapamil may increase the level of cyclosporine in your blood, increasing your risk of side effects. Your healthcare provider should monitor your cyclosporine levels and may need to adjust your dosage.
Digoxin (Digitek, Lanoxin)
Verapamil may increase the level of digoxin in your blood (although studies have shown conflicting results). Because changes in digoxin levels can be dangerous, your healthcare provider should monitor the level of digoxin in your blood and adjust your digoxin dosage as necessary. Your healthcare provider should also monitor your heart rate, as verapamil and digoxin can both lower your heart rate.
Disopyramide (Norpace)
Because both disopyramide and verapamil decrease the heart's ability to pump blood forcefully, disopyramide should not be taken within 48 hours before, or 24 hours after, taking verapamil.
Flecainide (Tambocor)
Combining verapamil with flecainide may decrease the heart's ability to pump blood forcefully and may decrease the heart rate too much. Your healthcare provider should monitor you closely when combining these two medications.
Grapefruit Juice
Grapefruit juice can increase the level of verapamil in your blood, increasing your risk of side effects. Grapefruit juice should be avoided in most cases. However, if your healthcare provider decides that it is okay for you to drink grapefruit juice, you should do so consistently and in moderation.
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