Drug interactions
Nebivolol + Neostigmine
Severity: Moderate
Nebivolol and Neostigmine: 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
Neostigmine increases cholinergic tone and can slow the heart rate. Together with nebivolol, bradycardia may be additive, especially around reversal of neuromuscular blockade.
What this interaction means in plain words
Nebivolol and Neostigmine 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.
Nebivolol belongs to Cardiovascular; Neostigmine belongs to Central Nervous System.
Why it happens
Additive bradycardia from cholinesterase inhibition (increased vagal tone) and beta-1 blockade.
What to do
Monitor heart rate and ECG when neostigmine is given to patients taking nebivolol, and have an anticholinergic such as glycopyrrolate or 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?
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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 Neostigmine
Frequently asked questions
Can I take Nebivolol with Neostigmine?
MediHelp rates the interaction as moderate. Nebivolol and Neostigmine 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. Neostigmine increases cholinergic tone and can slow the heart rate. Together with nebivolol, bradycardia may be additive, especially around reversal of neuromuscular blockade.
How serious is the interaction between Nebivolol and Neostigmine?
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 when neostigmine is given to patients taking nebivolol, and have an anticholinergic such as glycopyrrolate or atropine available.
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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