Drug interactions
Nebivolol + Propafenone
Severity: Major
Nebivolol and Propafenone: major 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
Propafenone strongly inhibits CYP2D6 and can substantially raise nebivolol exposure. Propafenone also has beta-blocking and negative inotropic effects, so bradycardia, AV block and hypotension are more likely.
What this interaction means in plain words
Nebivolol and Propafenone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Nebivolol belongs to Cardiovascular; Propafenone belongs to Cardiovascular.
Why it happens
Propafenone inhibits CYP2D6 metabolism of nebivolol, adding to its own beta-blocking activity.
What to do
Monitor heart rate, ECG and blood pressure, and start with a reduced nebivolol dose. Consider an alternative beta-blocker not dependent on CYP2D6 if bradycardia occurs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Nebivolol with Propafenone?
MediHelp rates the interaction as major. Nebivolol and Propafenone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Propafenone strongly inhibits CYP2D6 and can substantially raise nebivolol exposure. Propafenone also has beta-blocking and negative inotropic effects, so bradycardia, AV block and hypotension are more likely.
How serious is the interaction between Nebivolol and Propafenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate, ECG and blood pressure, and start with a reduced nebivolol dose. Consider an alternative beta-blocker not dependent on CYP2D6 if bradycardia occurs.
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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