Increased cardiac depressant effects (potentiation of negative chronotropic properties and conduction slowing effects) would be expected if amiodarone is given with diltiazem or verapamil. One case of sinus arrest and serious hypotension has been reported in a woman taking diltiazem with amiodarone.
It is advised that amiodarone should be avoided or used with caution with diltiazem or verapamil because cardiodepression may occur. Note that diltiazem has been used for rate control in patients developing postoperative atrial fibrillation despite the use of prophylactic amiodarone. There do not appear to be any reports of adverse effects attributed to the use of amiodarone with the dihydropyridine class of calcium-channel blockers (e.g. nifedipine), which typic- ally have little or no negative inotropic activity at usual doses.
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