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.