Drug interactions
Amiodarone + Esmolol
Severity: Major
Amiodarone and Esmolol: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs slow sinus node and AV nodal conduction, so combined use can cause marked bradycardia, AV block or hypotension. Amiodarone's long half-life prolongs this risk.
What this interaction means in plain words
Amiodarone and Esmolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Esmolol belongs to Cardiovascular.
Why it happens
Additive negative chronotropic and dromotropic effects from beta-blockade and amiodarone's multichannel blocking actions.
What to do
Use continuous ECG and blood pressure monitoring when esmolol is given to a patient on amiodarone, and titrate esmolol cautiously. Have measures for bradycardia available.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Esmolol
- Acebutolol + Esmolol Major
- Amifostine + Esmolol Major
- Celiprolol + Esmolol Major
- Diltiazem + Esmolol Major
- Epinephrine racemic + Esmolol Major
- Epinephrine + Esmolol Major
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Esmolol?
MediHelp rates the interaction as major. Amiodarone and Esmolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs slow sinus node and AV nodal conduction, so combined use can cause marked bradycardia, AV block or hypotension. Amiodarone's long half-life prolongs this risk.
How serious is the interaction between Amiodarone and Esmolol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use continuous ECG and blood pressure monitoring when esmolol is given to a patient on amiodarone, and titrate esmolol cautiously. Have measures for bradycardia available.
What other medicines interact with Esmolol?
MediHelp also lists interactions of Esmolol with, for example, Acebutolol, Amifostine, Celiprolol. The full list is on the Esmolol page.
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