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Atrial fibrillation - Management
What key drug interactions should I be aware of for calcium-channel blockers?
- Grapefruit may inhibit the metabolism of verapamil, resulting in increased plasma concentrations which could be clinically important.
- Verapamil should not be used with a beta-blocker because of the risk of reduced cardiac output and heart failure.
- Diltiazem should not be prescribed with a beta-blocker because bradycardia and atrioventricular block can occur. Asystole and sudden death have also been reported.
Basis for recommendation
- This information is taken from: the manufacturers' Summary of Product Characteristics [ABPI Medicines Compendium, 2007b]; Stockley's drug interactions: a source book of interactions, their mechanisms, clinical importance and management [Baxter, 2008]; and the Commission on Human Medicines (formerly the Committee on Safety of Medicines) [CSM, 1997].
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