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| Interactions: | Beta blockers: Additive effects lead-ing to heart failure, conduction disturbances, arrhythmias, and hypotension, especially it high beta-blocker doses are used, it drugs are administered IN., or if child has moderately severe to severe heart failure, severe cardiomyopathy, or recent MI. Monitor cardiac status closely.
Carbamazepine: Increased serum carbamazepine levels and subsequent toxicity. Use together with caution; watch for signs of toxicity.
Cyclosporine: Increased serum levels of cyclo-sporine. Monitor therapeutic effect; adjust dosage of cyclosporine as needed.
Digoxin: May increase serum digoxin levels by 50% to 75% during first week of therapy. Adjust digoxin dosage; monitor cardiac status closely.
Disopyramide: Combined negative inotropic ef-fects. Monitor child closely.
Flecainide: May add to negative inotropic effect and prolong AV conduction. Monitor cardiac status.
Inhalation anesthetics: Excessive CV depression. Avoid concomitant use.
Lithium: May increase sensitivity of lithium ef-fects. Adjust lithium dosage as needed.
Neuromuscular blockers: Drug may potentiate their action. Adjust dosage of neuromuscular blockers as needed; monitor child closely.
Other antihypertensives, drugs that attenuate alpha-adrenergic response (such as methyldopa, prazosin) , quinidine (to treat hypertrophiC Car-diomyopathy): Hypotension, Monitor blood pres-sure closely. Adjust dosage of either drug as needed.
Phenobarbital: May increase verapamil clear-ance. Monitor cardiac status.
Rifampin: May substantially reduce verapamils oral bioavailability. Monitor therapeutic effect; ad-just dosage of verapamil as needed.
Theophylline: Increased theophylline plasma lev-els. Monitor child closely; adjust theophylline dosage as needed.
Drug-food: Increased absorption. Child should take drug with food. Drug-lifestyle. |
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