MajorSelective beta-adrenergic blockers×Calcium channel blocker, non-DHP (benzothiazepine derivative)
Updated · Methodology
Mechanism
Non-dihydropyridine calcium channel blocker (diltiazem) + beta-blocker (bisoprolol) – additive AV node blockade and negative inotropic effect.
Symptoms
Bradycardia (heart rate below 50/min), dizziness, syncope. ECG: first- to second-degree AV block. Older patients: fall risk.
Management
Avoid the combination. For atrial fibrillation rate control, choose bisoprolol + digoxin (without diltiazem) or diltiazem with bisoprolol withdrawn.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Cardizem section 7 (2014)– ; DailyMed setid f3e7ecef-f360-4987-a4f5-933214130ab2
- AEMPS: Ficha técnica: Bisoprolol (nº registro 78903), sección 4.5 (2026)– AEMPS, CIMA, nº registro 78903, revisión 05/2026, sección 4.5