Bradycardia Risk Associated with Various Medications

Medications Known to Cause Bradycardia

• Beta-blockers cause bradycardia through SA and AV nodal effects, as recommended by the American Heart Association 1, 2, 3
• Nondihydropyridine calcium channel blockers, such as diltiazem and verapamil, produce bradycardia and AV block, according to the European Society of Cardiology 2, 3, 4
• Digoxin can cause bradyarrhythmias, particularly in toxicity, as noted by the European Heart Journal 2
• Amiodarone and sotalol are associated with bradycardia requiring pacemaker implantation, as reported by the American College of Cardiology 5, 6
• Ivabradine is specifically designed to slow heart rate, with excess bradycardia as a known risk when combined with other rate-lowering agents, as stated by the American Heart Association 1, 7, 8

Considerations for Combination Therapy

• If a patient on Entresto is also taking beta-blockers or other rate-controlling medications, bradycardia could occur from those agents, not from Entresto itself, as cautioned by the American Society of Hypertension 9, 4