Drug interactions
Nebivolol + Paroxetine
Severity: Moderate
Nebivolol and Paroxetine: 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
Paroxetine strongly inhibits CYP2D6, the main route of nebivolol metabolism, and raises nebivolol exposure in extensive metabolizers. This can cause excessive bradycardia and hypotension.
What this interaction means in plain words
Nebivolol and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
Inhibition of CYP2D6-mediated nebivolol metabolism increases plasma concentrations of the parent drug.
What to do
Monitor heart rate and blood pressure when starting or stopping paroxetine and titrate nebivolol to response. Use a lower nebivolol dose or an SSRI with weaker CYP2D6 inhibition if bradycardia develops.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Nebivolol with Paroxetine?
MediHelp rates the interaction as moderate. Nebivolol and Paroxetine 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. Paroxetine strongly inhibits CYP2D6, the main route of nebivolol metabolism, and raises nebivolol exposure in extensive metabolizers. This can cause excessive bradycardia and hypotension.
How serious is the interaction between Nebivolol and Paroxetine?
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 blood pressure when starting or stopping paroxetine and titrate nebivolol to response. Use a lower nebivolol dose or an SSRI with weaker CYP2D6 inhibition if bradycardia develops.
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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