Drug interactions
Physostigmine + Propranolol
Severity: Moderate
Physostigmine and Propranolol: 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 cause bradycardia, and propranolol adds negative chronotropic effects. Beta-blockers may also worsen bronchospasm provoked by cholinesterase inhibition.
What this interaction means in plain words
Physostigmine and Propranolol 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 bradycardic effects from cholinesterase inhibition and beta-blockade.
What to do
Monitor heart rate and ECG during physostigmine administration. 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 Propranolol
- Propranolol + Thioridazine Contraindicated
- Acebutolol + Propranolol Major
- Adrenaline-articaine + Propranolol Major
- Albuterol + Propranolol Major
- Amifostine + Propranolol Major
- Amiodarone + Propranolol Major
Frequently asked questions
Can I take Physostigmine with Propranolol?
MediHelp rates the interaction as moderate. Physostigmine and Propranolol 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 cause bradycardia, and propranolol adds negative chronotropic effects. Beta-blockers may also worsen bronchospasm provoked by cholinesterase inhibition.
How serious is the interaction between Physostigmine and Propranolol?
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. Have atropine available.
What other medicines interact with Propranolol?
MediHelp also lists interactions of Propranolol with, for example, Thioridazine, Acebutolol, Adrenaline-articaine. The full list is on the Propranolol page.
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