Drug interactions
Cocaine + Esmolol
Severity: Moderate
Cocaine 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
Beta-blockade in the presence of cocaine may leave alpha-adrenergic vasoconstriction unopposed, causing hypertension and coronary vasospasm. With topical cocaine systemic exposure is limited but not absent.
What this interaction means in plain words
Cocaine 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.
Cocaine belongs to Central Nervous System; Esmolol belongs to Cardiovascular.
Why it happens
Cocaine blocks catecholamine reuptake, and beta-blockade leaves alpha-mediated vasoconstriction unopposed.
What to do
Avoid beta-blockers in acute cocaine intoxication; monitor blood pressure and for chest pain if topical cocaine is used.
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 Esmolol
- Acebutolol + Esmolol Major
- Amifostine + Esmolol Major
- Amiodarone + Esmolol Major
- Celiprolol + Esmolol Major
- Diltiazem + Esmolol Major
- Epinephrine racemic + Esmolol Major
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Esmolol?
MediHelp rates the interaction as moderate. Cocaine 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. Beta-blockade in the presence of cocaine may leave alpha-adrenergic vasoconstriction unopposed, causing hypertension and coronary vasospasm. With topical cocaine systemic exposure is limited but not absent.
How serious is the interaction between Cocaine 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: Avoid beta-blockers in acute cocaine intoxication; monitor blood pressure and for chest pain if topical cocaine is used.
What other medicines interact with Esmolol?
MediHelp also lists interactions of Esmolol with, for example, Acebutolol, Amifostine, Amiodarone. The full list is on the Esmolol page.
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