Karvedilol ve Verapamil etkileşimi

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents.

As with other β-blockers, if COREG is administered with calcium channel blockers of the verapamil or diltiazem type, it is recommended that ECG and blood pressure be monitored.

Verapamil- or diltiazem-type calcium channel blockers may affect ECG and/or blood pressure.

Calcium Channel Blockers Conduction disturbance (rarely with hemodynamic compromise) has been observed when COREG is coadministered with diltiazem.

Beta blockers: reports of excess bradycardia and AV block, including complete heart block; monitor closely ( 7.4 )

Beta Blockers Concomitant therapy with beta-adrenergic blockers and verapamil may result in additive negative effects on heart rate, atrioventricular conduction, and/or cardiac contractility.

Antihypertensive Agents Verapamil administered concomitantly with oral antihypertensive agents (e.g., vasodilators, angiotensin-converting enzyme inhibitors, diuretics, beta blockers) will usually have an additive effect on lowering blood pressure.

Avoid verapamil in patients with severe left ventricular dysfunction (e.g., ejection fraction less than 30% or moderate to severe symptoms of cardiac failure) and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker [see Drug Interactions ( 7.4 )].

The combination of extended-release verapamil and beta-adrenergic blocking agents has not been studied.