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Verapamil increases digoxin levels significantly in most patients. Verapamil decreases renal and extrarenal clearance of digoxin. Serum digoxin levels may increase by 50% to 75% during the first week of concomitant verapamil therapy. Increases may be larger in patients with hepatic cirrhosis. Digoxin and verapamil have additive effects in slowing AV conduction. In clinical trials with digitalized patients with atrial fibrillation or atrial flutter, 15% of patients developed ventricular rates of less than 50/min and 5% developed asymptomatic hypotension....
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Verapamil increases digoxin levels significantly in most patients. Verapamil decreases renal and extrarenal clearance of digoxin. Serum digoxin levels may increase by 50% to 75% during the first week of concomitant verapamil therapy. Increases may be larger in patients with hepatic cirrhosis. Digoxin and verapamil have additive effects in slowing AV conduction. In clinical trials with digitalized patients with atrial fibrillation or atrial flutter, 15% of patients developed ventricular rates of less than 50/min and 5% developed asymptomatic hypotension.