Drug interactions
Levobunolol + Rivastigmine
Severity: Moderate
Levobunolol and Rivastigmine: 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
Rivastigmine can cause bradycardia and syncope through cholinergic effects, while levobunolol, a nonselective beta-blocker, can be absorbed systemically from eye drops and slow the heart rate. Together they may cause additive bradycardia, heart block or syncope.
What this interaction means in plain words
Levobunolol and Rivastigmine 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.
Levobunolol belongs to Miscellaneous; Rivastigmine belongs to Central Nervous System.
Why it happens
Additive negative chronotropic effects from cholinesterase inhibition and beta-adrenergic blockade.
What to do
Monitor heart rate and watch for dizziness or syncope, particularly after starting or increasing either drug. Consider a non-beta-blocker glaucoma agent in patients with bradycardia or conduction disease.
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 Rivastigmine
Other interactions of Levobunolol
- Clonidine + Levobunolol Moderate
- Digoxin + Levobunolol Moderate
- Diltiazem + Levobunolol Moderate
- Fingolimod + Levobunolol Moderate
- Levobunolol + Verapamil Moderate
Frequently asked questions
Can I take Levobunolol with Rivastigmine?
MediHelp rates the interaction as moderate. Levobunolol and Rivastigmine 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. Rivastigmine can cause bradycardia and syncope through cholinergic effects, while levobunolol, a nonselective beta-blocker, can be absorbed systemically from eye drops and slow the heart rate. Together they may cause additive bradycardia, heart block or syncope.
How serious is the interaction between Levobunolol and Rivastigmine?
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 watch for dizziness or syncope, particularly after starting or increasing either drug. Consider a non-beta-blocker glaucoma agent in patients with bradycardia or conduction disease.
What other medicines interact with Rivastigmine?
MediHelp also lists interactions of Rivastigmine with, for example, Donepezil, Galantamine, Memantine-donepezil. The full list is on the Rivastigmine page.
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