Drug interactions
Guanfacine + Nebivolol
Severity: Moderate
Guanfacine and Nebivolol: 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
If guanfacine is stopped abruptly while a beta blocker is being taken, unopposed alpha-adrenergic activity can produce a marked rebound rise in blood pressure. Together the two drugs also have additive effects on heart rate and blood pressure.
What this interaction means in plain words
Guanfacine and Nebivolol 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.
Guanfacine belongs to Cardiovascular; Nebivolol belongs to Cardiovascular.
Why it happens
Withdrawal of central alpha-2 agonism causes sympathetic surge, and beta blockade leaves alpha-mediated vasoconstriction unopposed.
What to do
Taper guanfacine gradually rather than stopping it suddenly, and monitor blood pressure and heart rate during any dose reduction. If both must be stopped, withdraw the beta blocker first.
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 Nebivolol
- Acebutolol + Nebivolol Major
- Aldesleukin + Nebivolol Major
- Amiodarone + Nebivolol Major
- Atenolol-chlorthalidone + Nebivolol Major
- Atenolol + Nebivolol Major
- Betaxolol + Nebivolol Major
Other interactions of Guanfacine
- Clonidine + Guanfacine Major
- Guanfacine + Lofexidine Major
- Aldesleukin + Guanfacine Moderate
- Amiodarone + Guanfacine Moderate
- Amisulpride + Guanfacine Moderate
- Amitriptyline + Guanfacine Moderate
Frequently asked questions
Can I take Guanfacine with Nebivolol?
MediHelp rates the interaction as moderate. Guanfacine and Nebivolol 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. If guanfacine is stopped abruptly while a beta blocker is being taken, unopposed alpha-adrenergic activity can produce a marked rebound rise in blood pressure. Together the two drugs also have additive effects on heart rate and blood pressure.
How serious is the interaction between Guanfacine and Nebivolol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Taper guanfacine gradually rather than stopping it suddenly, and monitor blood pressure and heart rate during any dose reduction. If both must be stopped, withdraw the beta blocker first.
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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