Interaction of Calcium Antagonists with β-Adrenoceptor Blocking Agents

  • L. Szekeres
  • J. Gy. Papp
Conference paper
Part of the Archives of Toxicology book series (TOXICOLOGY, volume 9)


Responsiveness to verapamil, the best studied calcium antagonist, was examined in cardiac preparations of rabbits pretreated with β-adrenoceptor blockers (propranolol 2 mg/kg or oxprenolol 4 mg/kg s.c.) twice daily for either one or six weeks. Using this dose-regimen, the degree of cardiac β-adrenoceptor blockade in conscious rabbits was substantial and similar for propranolol and oxprenolol. When administered for one week, neither proranolol nor oxprenolol affected to any marked extent the electrical and mechanical response to verapamil, diltiazem or fendiline in tissues isolated from various parts of the heart. In contrast, pretreatment with propranolol for six weeks resulted in a significant aggravation of the negative inotropic effect of verapamil in both atrial and ventricular muscle, and the verapamil-induced delay in atrio-ventricular and intra-ventricular conduction also became more pronounced. The same long-term administration of oxprenolol, one of the β-blockers with “intrinsic” sympathomimetic activity, did not alter the atrial or ventricular contractile response to verapamil and did not significantly increase the lengthening of atrio-ventricular conduction time occurring in the presence of verapamil It is concluded that from the point of view of adverse direct cardiac interactions with verapamil prolonged administration of oxprenolol appears to be less dangerous than chronic treatment with propranolol. It is also assumed that in those cases in which acute administration of verapamil may be necessary, concomitant chronic blockade of cardiac β-adrenoceptors is less dangerous if drugs known to possess not only β-adrenoceptor blocking properties, but also some “intrinsic” sympathomimetic activity are applied.

Key words

Cardiotoxicity Adverse drug interaction Negative inotropic effect Negative dromotropic effect β-adrenoceptor blockers Calcium antagonist Propranolol Oxprenolol Verapamil Diltiazem Fendiline 


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Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • L. Szekeres
    • 1
  • J. Gy. Papp
    • 1
  1. 1.Department of PharmacologyUniversity Medical School of SzegedSzegedHungary

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