Moderate
Acetylsalicylic acid × Verapamil
Antiplatelet agents (low dose) / NSAIDs (analgesic dose)×Non-dihydropyridine calcium channel blocker
Mechanism
At high doses, aspirin weakens verapamil's antihypertensive effect via vasodilator prostaglandin suppression. At cardioprotective doses, there is no clinically significant effect.
Symptoms
Gradual blood pressure rise at high aspirin doses. At cardioprotective doses, no significant changes.
Management
Cardioprotective aspirin doses (75–100 mg) are acceptable without adjustment. At high doses, monitor blood pressure and increase verapamil if needed. Alternative analgesic: paracetamol.