Drug interactions
Bisoprolol + Esmolol
Severity: Moderate
Bisoprolol and Esmolol: 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
Both are beta1-selective blockers, so giving esmolol to a patient on bisoprolol adds to existing beta-blockade. This may cause profound bradycardia, hypotension or heart block, although esmolol's short half-life limits the duration.
What this interaction means in plain words
Bisoprolol and Esmolol 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.
Bisoprolol belongs to Cardiovascular; Esmolol belongs to Cardiovascular.
Why it happens
Additive beta1-adrenergic receptor blockade.
What to do
Use esmolol only with continuous heart rate and blood pressure monitoring and start at a low infusion rate. Stop or reduce the infusion if bradycardia or hypotension develops.
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?
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Other interactions of Bisoprolol
Other interactions of Esmolol
- Acebutolol + Esmolol Major
- Amifostine + Esmolol Major
- Amiodarone + Esmolol Major
- Celiprolol + Esmolol Major
- Diltiazem + Esmolol Major
- Epinephrine racemic + Esmolol Major
Frequently asked questions
Can I take Bisoprolol with Esmolol?
MediHelp rates the interaction as moderate. Bisoprolol and Esmolol 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. Both are beta1-selective blockers, so giving esmolol to a patient on bisoprolol adds to existing beta-blockade. This may cause profound bradycardia, hypotension or heart block, although esmolol's short half-life limits the duration.
How serious is the interaction between Bisoprolol and Esmolol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use esmolol only with continuous heart rate and blood pressure monitoring and start at a low infusion rate. Stop or reduce the infusion if bradycardia or hypotension develops.
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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