Drug interactions
Atenolol + Neostigmine
Severity: Moderate
Atenolol and Neostigmine: moderate 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
Neostigmine increases cholinergic tone and can slow heart rate, and atenolol lowers heart rate through beta-blockade. Together they may produce additive bradycardia and, in susceptible patients, AV conduction delay.
What this interaction means in plain words
Atenolol and Neostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Atenolol belongs to Cardiovascular; Neostigmine belongs to Central Nervous System.
Why it happens
Additive negative chronotropic effects through enhanced vagal (muscarinic) stimulation plus beta-1 adrenergic blockade.
What to do
Monitor heart rate and ECG when neostigmine is given to a patient on atenolol, especially at reversal of neuromuscular block. Have an antimuscarinic such as glycopyrrolate or atropine available.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Atenolol and Neostigmine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Atenolol
- Amifostine + Atenolol Major
- Amiodarone + Atenolol Major
- Atenolol + Atenolol-chlorthalidone Major
- Atenolol + Betaxolol Major
- Atenolol + Bisoprolol Major
- Atenolol + Carvedilol Major
Other interactions of Neostigmine
Frequently asked questions
Can I take Atenolol with Neostigmine?
MediHelp rates the interaction as moderate. Atenolol and Neostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Neostigmine increases cholinergic tone and can slow heart rate, and atenolol lowers heart rate through beta-blockade. Together they may produce additive bradycardia and, in susceptible patients, AV conduction delay.
How serious is the interaction between Atenolol and Neostigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate and ECG when neostigmine is given to a patient on atenolol, especially at reversal of neuromuscular block. Have an antimuscarinic such as glycopyrrolate or atropine available.
What other medicines interact with Atenolol?
MediHelp also lists interactions of Atenolol with, for example, Amifostine, Amiodarone, Atenolol-chlorthalidone. The full list is on the Atenolol page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
