Drug interactions
Nadolol + Physostigmine
Severity: Moderate
Nadolol and Physostigmine: 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
Physostigmine increases cholinergic tone and can cause bradycardia and AV block, which may be additive with nadolol's negative chronotropic effect. Severe bradycardia or asystole is possible, particularly after rapid intravenous dosing.
What this interaction means in plain words
Nadolol and Physostigmine 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.
Why it happens
Additive bradycardic effects from cholinesterase inhibition and beta-blockade.
What to do
Monitor heart rate and ECG during physostigmine administration and have atropine available.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Nadolol and Physostigmine, 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 14 days on the web. No card needed.
Other interactions of Nadolol
- Acebutolol + Nadolol Major
- Adrenaline-articaine + Nadolol Major
- Albuterol + Nadolol Major
- Amifostine + Nadolol Major
- Amiodarone + Nadolol Major
- Arformoterol + Nadolol Major
Frequently asked questions
Can I take Nadolol with Physostigmine?
MediHelp rates the interaction as moderate. Nadolol and Physostigmine 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. Physostigmine increases cholinergic tone and can cause bradycardia and AV block, which may be additive with nadolol's negative chronotropic effect. Severe bradycardia or asystole is possible, particularly after rapid intravenous dosing.
How serious is the interaction between Nadolol and Physostigmine?
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 ECG during physostigmine administration and have atropine available.
What other medicines interact with Nadolol?
MediHelp also lists interactions of Nadolol with, for example, Acebutolol, Adrenaline-articaine, Albuterol. The full list is on the Nadolol 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.
