Drug interactions
Bisoprolol + Physostigmine
Severity: Moderate
Bisoprolol and Physostigmine: 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
Physostigmine increases cholinergic tone and can cause bradycardia and AV conduction slowing. Combined with bisoprolol, the risk of marked bradycardia or heart block is increased.
What this interaction means in plain words
Bisoprolol and Physostigmine 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.
Why it happens
Additive negative chronotropic and dromotropic effects from beta-blockade and cholinesterase inhibition.
What to do
Monitor heart rate and ECG during physostigmine administration, and have atropine available. Avoid the combination in patients with existing conduction block.
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
Frequently asked questions
Can I take Bisoprolol with Physostigmine?
MediHelp rates the interaction as moderate. Bisoprolol and Physostigmine 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. Physostigmine increases cholinergic tone and can cause bradycardia and AV conduction slowing. Combined with bisoprolol, the risk of marked bradycardia or heart block is increased.
How serious is the interaction between Bisoprolol and Physostigmine?
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 during physostigmine administration, and have atropine available. Avoid the combination in patients with existing conduction block.
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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