Drug interactions
Epinephrine racemic + Nebivolol
Severity: Major
Epinephrine racemic 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
Beta-blockers can blunt the bronchodilator and cardiac effects of epinephrine. Unopposed alpha stimulation may cause marked hypertension with reflex bradycardia, and anaphylaxis treatment may be less effective.
What this interaction means in plain words
Epinephrine racemic 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.
Why it happens
Beta-adrenergic blockade antagonizes epinephrine's beta effects, leaving alpha-adrenergic vasoconstriction unopposed.
What to do
Monitor blood pressure and heart rate closely when epinephrine is needed. In refractory anaphylaxis on beta-blockers, glucagon may be considered.
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 Nebivolol
- Acebutolol + Nebivolol Major
- Aldesleukin + Nebivolol Major
- Amiodarone + Nebivolol Major
- Atenolol-chlorthalidone + Nebivolol Major
- Atenolol + Nebivolol Major
- Betaxolol + Nebivolol Major
Frequently asked questions
Can I take Epinephrine racemic with Nebivolol?
MediHelp rates the interaction as major. Epinephrine racemic 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. Beta-blockers can blunt the bronchodilator and cardiac effects of epinephrine. Unopposed alpha stimulation may cause marked hypertension with reflex bradycardia, and anaphylaxis treatment may be less effective.
How serious is the interaction between Epinephrine racemic 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 needed. In refractory anaphylaxis on beta-blockers, glucagon may be considered.
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.
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