Drug interactions
Bisoprolol + Epinephrine racemic
Severity: Major
Bisoprolol and Epinephrine racemic: major interaction.
Last updated Sources: UK SmPC
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
Beta-blockade reduces the beta-mediated effects of epinephrine, while alpha-mediated vasoconstriction continues. This can cause marked hypertension with reflex bradycardia, and may reduce the response in anaphylaxis or bronchospasm.
What this interaction means in plain words
Bisoprolol and Epinephrine racemic 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.
Why it happens
Beta-adrenergic blockade leaves epinephrine's alpha-adrenergic vasoconstriction unopposed and antagonizes its beta effects.
What to do
Monitor blood pressure and heart rate closely. In anaphylaxis in a beta-blocked patient with poor response to epinephrine, consider glucagon.
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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References
Other interactions of Bisoprolol
Frequently asked questions
Can I take Bisoprolol with Epinephrine racemic?
MediHelp rates the interaction as major. Bisoprolol and Epinephrine racemic 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. Beta-blockade reduces the beta-mediated effects of epinephrine, while alpha-mediated vasoconstriction continues. This can cause marked hypertension with reflex bradycardia, and may reduce the response in anaphylaxis or bronchospasm.
How serious is the interaction between Bisoprolol and Epinephrine racemic?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and heart rate closely. In anaphylaxis in a beta-blocked patient with poor response to epinephrine, consider glucagon.
What other medicines interact with Bisoprolol?
MediHelp also lists interactions of Bisoprolol with, for example, Aldesleukin, Amifostine, Amiodarone. The full list is on the Bisoprolol page.
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