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Drug interactions

Nebivolol + Rivastigmine

Severity: Moderate

Nebivolol and Rivastigmine: 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

Rivastigmine increases cholinergic tone and can slow the heart rate, and beta-blockers add to this effect. The combination increases the risk of bradycardia, syncope, and falls, particularly in older adults.

What this interaction means in plain words

Nebivolol and Rivastigmine 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; Rivastigmine belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive bradycardic effects from vagotonic cholinesterase inhibition and beta-adrenergic blockade.

What to do

Monitor heart rate and watch for dizziness or syncope, particularly during initiation and dose titration. Reduce the dose or change therapy if symptomatic bradycardia occurs.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Nebivolol with Rivastigmine?

MediHelp rates the interaction as moderate. Nebivolol and Rivastigmine 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. Rivastigmine increases cholinergic tone and can slow the heart rate, and beta-blockers add to this effect. The combination increases the risk of bradycardia, syncope, and falls, particularly in older adults.

How serious is the interaction between Nebivolol and Rivastigmine?

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 watch for dizziness or syncope, particularly during initiation and dose titration. Reduce the dose or change therapy if symptomatic 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.

Full monographs, dosing and an interaction checker in the MediHelp app

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