Why the study?
Does the addition of dihydropyridine calcium channel blockers to mibefradil and beta-blockers cause life-threatening drug interactions?
Does the addition of dihydropyridine calcium channel blockers to mibefradil and beta-blockers cause life-threatening drug interactions?
The combination of mibefradil, beta-blockers, and dihydropyridine calcium channel blockers can lead to life-threatening cardiogenic shock.
Answers are grounded in this paper and cite their sources.
Observed cases suggest possible interaction with mibefradil, beta-blockers, and dihydropyridine calcium channel blockers; hypothesis-generating and should not yet change practice.
Mibefradil is a T-type and L-type calcium channel blocker (CCB) released in the United States in 1997 for management of hypertension and chronic stable angina. Postmarketing surveillance revealed a potential serious interaction between mibefradil and beta-blockers, digoxin, verapamil, and diltiazem, especially in elderly patients. The manufacturer voluntarily withdrew mibefradil on June 8, 1998. We describe 4 cases of cardiogenic shock in patients taking mibefradil and beta-blockers who began taking dihydropyridine CCBs. One case resulted in death; the other 3 survived episodes of cardiogenic shock with intensive support of heart rate and blood pressure. Physicians who are preparing to switch patients' medications from mibefradil to other antihypertensive agents should be aware of these potentially life-threatening drug-drug interactions.
No takes yet. Share an insight, caveat, or question.
Michael E. Mullins (1998) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: