Drug interactions
Epinephrine + Nebivolol
Severity: Major
Epinephrine and Nebivolol: 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
Nebivolol blocks beta-1 receptors and can blunt the cardiac and bronchodilator effects of epinephrine. Unopposed alpha stimulation by epinephrine may cause marked hypertension with reflex bradycardia, and epinephrine may be less effective in anaphylaxis.
What this interaction means in plain words
Epinephrine and Nebivolol 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.
Epinephrine belongs to Endocrine; Nebivolol belongs to Cardiovascular.
Why it happens
Pharmacodynamic antagonism at beta-adrenergic receptors, leaving alpha-mediated vasoconstriction unopposed.
What to do
Monitor blood pressure and heart rate closely when epinephrine is given to a patient taking nebivolol. In anaphylaxis unresponsive to epinephrine, consider glucagon and be prepared for higher doses and supportive care.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Epinephrine and Nebivolol, 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.
References
Other interactions of Nebivolol
- Acebutolol + Nebivolol Major
- Aldesleukin + Nebivolol Major
- Amiodarone + Nebivolol Major
- Atenolol-chlorthalidone + Nebivolol Major
- Atenolol + Nebivolol Major
- Betaxolol + Nebivolol Major
Other interactions of Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Epinephrine with Nebivolol?
MediHelp rates the interaction as major. Epinephrine and Nebivolol 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. Nebivolol blocks beta-1 receptors and can blunt the cardiac and bronchodilator effects of epinephrine. Unopposed alpha stimulation by epinephrine may cause marked hypertension with reflex bradycardia, and epinephrine may be less effective in anaphylaxis.
How serious is the interaction between Epinephrine and Nebivolol?
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 when epinephrine is given to a patient taking nebivolol. In anaphylaxis unresponsive to epinephrine, consider glucagon and be prepared for higher doses and supportive care.
What other medicines interact with Nebivolol?
MediHelp also lists interactions of Nebivolol with, for example, Acebutolol, Aldesleukin, Amiodarone. The full list is on the Nebivolol 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.
