Drug interactions
Nebivolol + Physostigmine
Severity: Moderate
Nebivolol 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 slow heart rate, and nebivolol also lowers heart rate and slows AV conduction. Together they may cause significant bradycardia or heart block.
What this interaction means in plain words
Nebivolol 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 negative chronotropic effects via 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?
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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
Frequently asked questions
Can I take Nebivolol with Physostigmine?
MediHelp rates the interaction as moderate. Nebivolol 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 slow heart rate, and nebivolol also lowers heart rate and slows AV conduction. Together they may cause significant bradycardia or heart block.
How serious is the interaction between Nebivolol 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 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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