The combination of verapamil or diltiazem with beta-blockers should be avoided because of potentially profound adverse effects on AV (atrioventricular) nodal conduction, heart rate, or cardiac contractility. This effect is unpredictable but may be enhanced due to CYP2D6 poor metabolizer status which could be a special vulnerability factor.
Keywords: CYP2D6; cardiac insufficiency; cardiovascular toxicology; drug‐drug interaction; metoprolol; verapamil.
© 2019 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.