Skip to main content
SpringerLink
Log in

β-Blockers

Drug Interactions of Clinical Significance

  • Review Article
  • Drug Experience
  • Published:
Drug Safety Aims and scope Submit manuscript

Summary

The clinician prescribing β-blockers for his or her patients is faced with an often difficult situation. There are many β-blockers, each with its own pharmacological profile. Patients are often taking multiple medications, thus increasing the risk of both anticipated and unexpected drug interactions. Reports of drug interactions are frequently anecdotal. The prescriber may not be aware of the patient’s other medications or lifestyle habits. Pharmacokinetic and pharmacodynamic drug interactions involving β-blockers are documented in the literature, but these studies often examine small numbers of patients. For these reasons, it is difficult for the practitioner to distill guidelines for the administration of β-blockers in conjunction with other medication. In general, β-blockers are well tolerated, and symptomatic drug interactions are relatively infrequent. It is incumbent upon the clinical practitioner to have knowledge of his or her patient’s drug profile and to be aware of the various drug interactions as well as each patient’s unique pathophysiological profile when prescribing any medication, including β-blockers.

β-Blockers may interact with a large number of commonly prescribed drugs, including antihypertensive and antianginal drugs, inotropic agents, antiarrhythmics, NSAIDs, psychotropic drugs, anti-ulcer medications, anaesthetics, HMG-CoA reductase inhibitors, warfarin, oral hypoglycaemics and rifampicin (rifampin).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Beeley L. Drug interactions and beta-blockers. BMJ 1984; 289: 1330–1

    PubMed  CAS  Google Scholar 

  2. McDevitt D G. Drug interactions involving beta-adrenoreceptor blocking drugs. Cardiovasc Respir Dis Ther 1980; 1: 21–41

    CAS  Google Scholar 

  3. Wood AJJ, Feely J. Pharmacokinetic drug interactions with propranolol. Clin Pharmacokinet 1983; 8: 253–62

    PubMed  CAS  Google Scholar 

  4. Heagerty AM, Donovan MA, Castleden CM, et al. Influence of cimetidine on pharmacokinetic s of propranolol. BMJ 1981; 282: 1917–9

    PubMed  CAS  Google Scholar 

  5. Kirch W, Kohler H, Spahn H, et al. Interaction of cimetidine with metoprolol, propranolol or atenolol. Lancet 1981; ii: 531–2

    Google Scholar 

  6. Kater RMH, Roggin G, Tobboon F, et al. Increased rate of clearance of drugs from the circulation of alcoholics. Am J Med Sci 1969; 258: 35–9

    PubMed  CAS  Google Scholar 

  7. Jusko WJ. Role of tobacco smoking in pharmacokinetics. J Pharmacokinet Biopharm 1978; 6: 7–39

    PubMed  CAS  Google Scholar 

  8. Deanfield J, Wright C, Krikler S, et al. Cigarette smoking and the treatment of angina with propranolol, atenolol, and nifedipine. N Engl J Med 1984; 310(15): 951–4

    PubMed  CAS  Google Scholar 

  9. Walle T, Walle UK, Cowart TD, et al. Selective induction of propranolol metabolism by smoking: additional effects on renal clearance of metabolites. J Pharmacol Exp Ther 1987; 241: 928–33

    PubMed  CAS  Google Scholar 

  10. Sotaniemi EA, Anttila M, Rautio A, et al. Propranolol and sotalol metabolism after a drinking party. Clin Pharmacol Ther 1981; 29(6): 705–10

    PubMed  CAS  Google Scholar 

  11. Orme MLE. Social drinking and drugs. BMJ 1981; 283: 1489–90

    PubMed  CAS  Google Scholar 

  12. Kirch W, Spahn H, Hutt HJ, et al. Interaction between alcohol and metoprolol or atenolol in social drinking. Drugs 1983; 25 Suppl. 2: 152

    Google Scholar 

  13. Packer M, Meller J, Medina N, et al. Haemodynamic consequences of combined beta-adrenergic and slow calcium channel blockade in man. Circulation 1982; 65(4): 660–8

    PubMed  CAS  Google Scholar 

  14. Rowland E, Razis P, Sugrue D, et al. Acute and chronic haemodynamic and electrophysiological effects of nifedipine in patients receiving atenolol. Br Heart J 1983; 50: 383–9

    PubMed  CAS  Google Scholar 

  15. Lynch P, Dargie H, Krikler S, et al. Objective assessment of antianginal treatment: a double blind comparison of propranolol, nifedipine, and their combination. BMJ 1980; 281: 184–7

    PubMed  CAS  Google Scholar 

  16. Findlay I, Gillen G, Elliott AT, et al. Calcium antagonists and beta-blockers in angina: a beneficial drug interaction?. [abstract] Eur Heart J 1985; 6 Suppl. 1: 238

    Google Scholar 

  17. Opie L H, Jee L, White D. Antihypertensive effects of nifedipine combined with cardioselective beta-adrenergic receptor antagonism by atenolol. Am Heart J 1982; 104(3): 606–12

    PubMed  CAS  Google Scholar 

  18. Robinson K, Krikler S, Krikler DM. Comparative study of the effect of nifedipine versus diltiazem on exercise performance, serum propranolol levels, and ST segment abnormalities in patients with chronic stable angina taking propranolol. Am J Cardiol 1989; 64: 27F–30F

    PubMed  CAS  Google Scholar 

  19. Robson RH, Vishwanath MC. Nifedipine and beta-blockade as a cause of cardiac failure. BMJ 1982; 284: 104

    PubMed  CAS  Google Scholar 

  20. Packer M. Combined beta-adrenergic and calcium-entry blockade in angina pectoris. N Engl J Med 1989; 320: 709–18

    PubMed  CAS  Google Scholar 

  21. Gangji D, Juvent M, Niset G, et al. Study of the influence of nifedipine on the pharmacokinetics and pharmacodynamics of propranolol, metoprolol and atenolol. Br J Clin Pharmacol 1984; 17 Suppl. 1: 29S–35S

    PubMed  Google Scholar 

  22. Bauer LA, Murray K, Horn JR, et al. Influence of nifedipine therapy on indocyanine green and oral propranolol pharmacokinetics. Eur J Clin Pharmacol 1989; 37: 257–60

    PubMed  CAS  Google Scholar 

  23. Kleinbloesem CH, van Brummelen P, van de Linde JA, et al. Nifedipine: kinetics and dynamics in healthy subjects. Clin Pharmacol Ther 1984; 35(6): 742–9

    PubMed  CAS  Google Scholar 

  24. Benaim ME. Asystole after verapamil. BMJ 1972; 2: 169

    PubMed  CAS  Google Scholar 

  25. Keech AC, Harper RW, Harrison PM, et al. Pharmacokinetic interaction between oral metoprolol and verapamil for angina pectoris. Am J Cardiol 1986; 58(6): 551–2

    PubMed  CAS  Google Scholar 

  26. Findlay IN, McInnes GT, Dargie HJ. Beta-blockers and verapamil: a cautionary tale. BMJ 1984: 289: 1074

    PubMed  CAS  Google Scholar 

  27. Findlay IN, MacLeod K, Gillen G, et al. A double blind placebo controlled comparison of verapamil, atenolol, and their combination in patients with chronic stable angina pectoris. Br Heart J 1987; 57: 336–43

    PubMed  CAS  Google Scholar 

  28. Pringle SD, MacEwen CJ. Severe bradycardia due to interaction of timolol eye drops and verapamil. BMJ 1987; 294: 155–6

    PubMed  CAS  Google Scholar 

  29. Frishman WH, Fuksbrumer M, Tannenbaum M. Topical ophthalmic β-adrenergic blockade for the treatment of glaucoma and ocular hypertension. J Clin Pharmacol 1994; 34: 795–803

    PubMed  CAS  Google Scholar 

  30. Warrington SJ, Holt D, Johnston A, et al. Pharmacokinetics and pharmacodynamics of verapamil in combination with atenolol, metoprolol, and propranolol. Br J Clin Pharmacol 1984; 17 Suppl. 1: 37S–44S

    PubMed  Google Scholar 

  31. Freeman D, DePietro L, Carruthers G. Influence of verapamil on the acute and chronic effects and pharmacokinetics of propranolol. [abstract] The Second World Conference on Clinical Pharmacology and Therapeutics: 1983 Jul 31–Aug 5; Washington, DC

  32. McLean AJ, Knight R, Harrison PM, et al.Clearance based oral drug interaction between verapamil and metoprolol and comparison with atenolol. Am J Cardiol 1985; 55: 1628–9

    PubMed  CAS  Google Scholar 

  33. Keech AC, Harper RW, Harrison PM, et al. Extent and pharmacokinetic mechanisms of oral atenolol-verapamil interaction in man. Eur J Clin Pharmacol 1988; 35(4): 363–6

    PubMed  CAS  Google Scholar 

  34. Carruthers SG, Freeman DJ, Bailey DG. Synergistic adverse hemodynamic interaction between oral verapamil and propranolol. Clin Pharmacol Ther 1989; 46: 469–77

    PubMed  CAS  Google Scholar 

  35. Oesterle SN, Alderman EL, Beier-Scott L, et al. Diltiazem and propranolol in combination: hemodynamic effects following acute intravenous administration. Am Heart J 1986; 111(3): 489–97

    PubMed  CAS  Google Scholar 

  36. Hunt BA, Bottorff MB, Herring VL, et al. Effects of calcium channel blockers on the pharmacokinetics of propranolol stereoisomers. Clin Pharmacol Ther 1990; 47: 584–91

    PubMed  Google Scholar 

  37. Tateishi T, Nakashima H, Shitou T, et al. Effect of diltiazem on the pharmacokinetics of propranolol, metoprolol and atenolol. Eur J Clin Pharmacol 1989; 36: 67–70

    PubMed  CAS  Google Scholar 

  38. Uzubalia RI, Frewin DB, Bushell MK, et al. The effect of angiotensin converting enzyme inhibitors (ACE-I) and selective β1-antagonists on bronchial reactivity and the cough reflex in man. Eur J Clin Pharmacol 1989; 37: 467–70

    Google Scholar 

  39. Belz GG, Essig J, Kleinblowsem CH, et al. Interactions between cilazapril and propranolol in man; plasma drug concentrations, hormone and enzyme responses, haemodynamics, agonist dose-effect curves and baroreceptor reflexes. Br J Clin Pharmacol 1988; 26: 547–56

    PubMed  CAS  Google Scholar 

  40. Horvath AM, Pilon D, Caille G, et al. Multiple-dose propranolol administration does not influence the single dose pharmacokinetics of quinapril and its active metabolite (quinaprilat). Biopharm Drug Dispos 1990; 11: 191–6

    PubMed  CAS  Google Scholar 

  41. Kang PM, Landau AJ, Eberhardt RT, et al. Angiotensin II receptor antagonists: a new approach to blockade of the reninangiotensin system. Am Heart J 1994; 127: 1388–401

    PubMed  CAS  Google Scholar 

  42. Reeves RA, Smith DL, Leenen FHH. Hemodynamic interaction of nonselective vs beta-1-selective beta-blockade with hydralazine in humans. Clin Pharmacol Ther 1987; 41: 326–35

    PubMed  CAS  Google Scholar 

  43. McLean AJ, Skews H, Bobik A, et al. Interaction between oral propranolol and hydralazine. Clin Pharmacol Ther 1980; 27(6): 726–32

    PubMed  CAS  Google Scholar 

  44. McLean AJ, Wilhelm D, Heinzow BG, et al. Stable oral availability of atenolol coadministered with hydralazine. Comparison with propranolol, metoprolol and other beta-adrenoreceptor antagonists. Drugs 1983; 25 Suppl. 2: 131–5

    CAS  Google Scholar 

  45. Schneck DW, Vary JE. Mechanism by which hydralazine increases propranolol bioavailability. Clin Pharmacol Ther 1984; 35(4): 447–53

    PubMed  CAS  Google Scholar 

  46. Byrne AJ, McNeil JJ, Harrison PM, et al. Stable oral availability of sustained release propranolol when co-administered with hydralazine or food-evidence implicating substrate delivery rate as a determinant of presystemic drug interactions. Br J Clin Pharmacol 1984; 17 Suppl. 1; 45S–50S

    PubMed  Google Scholar 

  47. Sloos R, van Zwieten PA. Pressor effect of beta-adrenergic receptor blocking drugs in spontaneously hypertensive rats treated with clonidine. J Cardiovasc Pharmacol 1979; 1: 441–8

    PubMed  CAS  Google Scholar 

  48. Warren SE, Ebert E, Swerdlin A-H, et al.Clonidine and propranolol — paradoxical hypertension. Arch Intern Med 1979; 139(2): 253

    PubMed  CAS  Google Scholar 

  49. Bailey RR, Neale TJ. Rapid clonidine withdrawal with blood pressure overshoot exaggerated by beta blockade. BMJ 1976; 1: 942–3

    PubMed  CAS  Google Scholar 

  50. Lilja M, Jounela AJ, Juustila HJ, et al. Abrupt and gradual change from clonidine to beta-blockers in hypertension. Acta Med Scand 1982; 211: 375–80

    PubMed  CAS  Google Scholar 

  51. Rosenthal T, Rabinowitz B, Boichis H, et al. Use of labetalol in hypertensive patients during discontinuation of clonidine therapy. Eur J Clin Pharmacol 1981; 20: 237–40

    PubMed  CAS  Google Scholar 

  52. Elliott HL, McLean K, Sumner DJ, et al. Immediate cardiovascular responses to oral prazosin — effects of concurrent beta-blockers. Clin Pharmacol Ther 1981; 29(3): 379–85

    Google Scholar 

  53. Englert RG, Barlage U. The addition of doxazosin to the treatment regimen of patients with hypertension not adequately controlled by beta-blockers. Am Heart J 1991 Jan; 121 (1 Pt 2): 311–6

    PubMed  CAS  Google Scholar 

  54. Searle M, Dathan R, Dean S, et al. Doxazosin in combination with atenolol in essential hypertension: a double-blind placebo-controlled multicentre trial. Eur J Clin Pharmacol 1990; 39(3): 299–300

    PubMed  CAS  Google Scholar 

  55. Saunders E. The safety and efficacy of terazosin in the treatment of essential hypertension in blacks. Am Heart J 1991 Sep; 122 (3 Pt 2): 936–42

    PubMed  CAS  Google Scholar 

  56. Pool JL.Combination antihypertensive therapy with terazosin and other antihypertensive agents: results of clinical trials. Am Heart J 1991 Sep; 122 (3 Pt 2): 926–31

  57. Cohen JD. Long-term efficacy and safety of terazosin alone and in combination with other antihypertensive agents. Am Heart J 1991 Sep; 122 (3 Pt 2): 919–25

    PubMed  CAS  Google Scholar 

  58. Patten SB, Love EJ. Drug-induced depression. Drug Saf 1994; 10(3): 203–19

    PubMed  CAS  Google Scholar 

  59. Fortin TL, Sundaresan PR. Reserpine up-regulation of rat renal cortical beta adrenergic receptors is independent of its effect on the sympathetic nervous system. J Pharmacol Exp Ther 1990; 253(3): 913–20

    PubMed  CAS  Google Scholar 

  60. Williams RG, Broadley KJ. Determination of agonist affinity for cardiac beta-adrenoceptors during reserpine-induced supersensitivity. Eur J Pharmacol 1983; 87(1): 95–105

    PubMed  CAS  Google Scholar 

  61. Bogaert MG, Rosseel MT, Lefebvre RA. Lack of pharmacokinetic interaction between isosorbide dinitrate and the beta-adrenergic blockers atenolol and propranolol. Br J Clin Pharmacol 1984: 17 Suppl. 1: 90S–91S

    PubMed  Google Scholar 

  62. Catalano PM. Possible interaction of epinephrine with propranolol. J Am Acad Dermatol 1984; 10(5): 839

    PubMed  CAS  Google Scholar 

  63. Foster CA, Aston SJ. Propranolol-epinephrine interaction: a potential disaster. Plast Reconstr Surg 1983; 72(1): 74–8

    PubMed  CAS  Google Scholar 

  64. Branch RA, Shand DG, Nies AS. Increase in hepatic blood flow and d-propranolol clearance by glucagon in the monkey. J Pharmacol Exp Ther 1973; 187(3): 581–7

    PubMed  CAS  Google Scholar 

  65. Frishman WH, Sonnenblick EH. Beta-adrenergic blocking drugs. In: Schlant RC, Alexander RW, editors. The heart. 8 ed. New York: McGraw Hill Inc., 1994: 1271–90

    Google Scholar 

  66. Frishman WH, Jacob H, Eisenberg ES, et al. Overdosage with β-adrenoceptor blocking drugs: pharmacologic considerations and clinical management. In: Frishman WH, editor. Clinical pharmacology of the β-adrenoceptor blocking drugs. Norwalk, Conn.: Appleton-Century-Crofts, 1984: 169–203

    Google Scholar 

  67. Weissman NJ, Levangie MW, Newell JB, et al. Effect of β-adrenergic receptor blockade on the physiologic response to dobutamine stress echocardiography. Am Heart J 1995; 130: 248–53

    PubMed  CAS  Google Scholar 

  68. Hansen PB, Buch J, Rasmussen OO, et al. Influence of atenolol and nifedipine on digoxin-induced inotropism in humans. Br J Clin Pharmacol 1984; 18: 817–22

    PubMed  CAS  Google Scholar 

  69. Wilcox RG, Hampton JR, Rowley JM. Randomised placebocontrolled trial comparing oxprenolol with disopyramide phosphate in immediate treatment of suspected myocardial infarction. Lancet 1980; ii: 765–9

    Google Scholar 

  70. Cumming AD, Robertson D. Interaction between disopyramide and practolol. BMJ 1979; 2: 1264

    PubMed  CAS  Google Scholar 

  71. Bonde J, Bodtker S, Angelo HR, et al. Atenolol inhibits the elimination of disopyramide. Eur J Clin Pharmacol 1985: 28: 41–3

    PubMed  CAS  Google Scholar 

  72. Cavusoglu E, Frishman W. Sotalol: a new β-adrenergic blocker for ventricular arrhythmias. Prog Cardiovasc Dis 1995; XXXVII(6): 423–40

    Google Scholar 

  73. Wagner F, Kalusche D, Trenk D, et al. Drug interaction between propafenone and metoprolol. Br J Clin Pharmacol 1987; 24: 213–20

    PubMed  CAS  Google Scholar 

  74. Kowey PR, Kirsten EB, Chau-Hwei JF, et al. Interaction between propranolol and propafenone in healthy volunteers. J Clin Pharmacol 1989; 29(6): 512–7

    PubMed  CAS  Google Scholar 

  75. Kinney EL. Orthostatic hypotension due to quinidine and propranolol. Am J Med 1987; 82: 1276–7

    PubMed  CAS  Google Scholar 

  76. Manolis AS, Estes NA. Orthostatic hypotension due to quinidine and atenolol. Am J Med 1987; 82: 1083–4

    PubMed  CAS  Google Scholar 

  77. Hori R, Okumura K, Yasuhara M, et al. Alteration of propranolol pharmacokinetics by quinidine in man and rat. The Second World Conference on Clinical Pharmacology and Therapeutics: 1983 Jul 31–Aug 5; Washington, DC

  78. Zhou H-H, Anthony LB, Roden DM, et al. Quinidine reduces clearance of (+)-propranolol more than (−)-propranolol through marked reduction in 4-hydroxylation. Clin Pharmacol Ther 1990; 457: 686–93

    Google Scholar 

  79. Leor J, Levartowsky D, Sharon C, et al. Amiodarone and β-adrenergic blockers: an interaction with metoprolol but not with atenolol. Am Heart J 1988; 116: 206–7

    PubMed  CAS  Google Scholar 

  80. Bashir Y, Paul VE, Griffith MJ, et al. A prospective study of the efficacy and safety of adjuvant metoprolol and xamoterol in combination with amiodarone for resistant ventricular tachycardia associated with impaired left ventricular function. Am Heart J 1992 Nov; 124(5): 1233–40

    PubMed  CAS  Google Scholar 

  81. Bax NDS, Tucker GT, Lennard MS, et al. The impairment of lignocaine clearance by propranolol — major contribution from enzyme inhibition. Br J Clin Pharmacol 1985; 19: 597–603

    PubMed  CAS  Google Scholar 

  82. Conrad KA, Byers JM, Finley PR, et al. Lidocaine elimination: effects of metoprolol and of propranolol. Clin Pharmacol Ther 1983: 33(2): 133–8

    PubMed  CAS  Google Scholar 

  83. Lysbo Svendsen T, Tango M, Waldorff S, et al. Effects of propranolol and pindolol on plasma lignocaine clearance in man. Br J Clin Pharmacol 1982; 13: 223S–6S

    Google Scholar 

  84. Miners JO, Wing LMH, Lillywhite KJ, et al. Failure of ‘therapeutic’ doses of beta-adrenoreceptor antagonists to alter the disposition of tolbutamide and lignocaine. Br J Clin Pharmacol 1984; 18: 853–60

    PubMed  CAS  Google Scholar 

  85. Deacon CS, Lennard MS, Bax NDS, et al. Inhibition of oxidative drug metabolism by beta-adrenoceptor antagonists is related to their lipid solubility. Br J Clin Pharmacol 1981; 12: 429–31

    PubMed  CAS  Google Scholar 

  86. Schneck DW, Luderer JR, Davis D, et al. Effects of nadolol and propranolol on plasma lidocaine clearance. Clin Pharmacol Ther 1984; 36(5): 584–7

    PubMed  CAS  Google Scholar 

  87. Lewis RV, Toner JM, Jackson PR, et al. Effects of indomethacin and sulindac on blood pressure of hypertensive patients. BMJ 1986; 293: 934–5

    Google Scholar 

  88. Wennmalm A. Hypertensive effect of the prostaglandin synthesis inhibitor indomethacin IRCS Research on Cardiovascular System. Clin Pharmacol Ther 1974; 2: 1099

    CAS  Google Scholar 

  89. Salvetti A, Pedrinelli R, Alberici P, et al. The influence of indomethacin and sulindac on some pharmacological actions of atenolol in hypertensive patients. Br J Clin Pharmacol 1984; 17 Suppl. 1: 108S–11S

    PubMed  Google Scholar 

  90. Durao V, Martins Prata M, Pires Goncalves LM. Modification of antihypertensive effect of beta-adrenoceptor blocking agents by inhibition of endogenous prostaglandin synthesis. Lancet 1977; ii: 1005–7

    Google Scholar 

  91. Szeigoleit W, Korner C, Hofmann H. Klinisch pharmakologische Untersuchungen zum Einfluss von Indomethicin Und Acetylsalicylsaure aud die antiarrhythmische Wirkung von Propanolol. Z Klin Med 1989; 44: 241–3

    Google Scholar 

  92. Feuerstein G, Torda T, Kopin IJ. Effect of indomethacin on cardiac beta-adrenergic receptors. Eur J Pharmacol 1980; 67: 469–72

    PubMed  CAS  Google Scholar 

  93. Sonne J, Dossing M, Loft S, et al. Single dose pharmacokinetics and pharmacodynamics of oral oxazepam during concomitant administration of propranolol and labetalol. Br J Clin Pharmacol 1990; 29: 33–7

    PubMed  CAS  Google Scholar 

  94. Frishman WH, Razin A, Swenciones C, et al. Update: β-adrenergic blockade in anxiety states. Cardiovasc Rev Rep 1992; 13(2): 8–31

    Google Scholar 

  95. Frishman WH, Nurenberg M, Spiegel A. Cardiovascular considerations with use of psychoactive medications. Am J Ther. In press

  96. Feely J, Wilkinson GR, Wood AJJ. Reduction of liver blood flow and propranolol metabolism by cimetidine. N Engl J Med 1981; 304(12): 692–5

    PubMed  CAS  Google Scholar 

  97. Houtzagers JJR, Streurman O, Regardh CG. The effect of pretreatment with cimetidine on the bioavailability and disposition of atenolol and metoprolol. Br J Clin Pharmacol 1982; 14: 67–72

    PubMed  CAS  Google Scholar 

  98. Ellis ME, Hussain M, Webb AK, et al. The effect of cimetidine on the relative cardioselectivity of atenolol and metoprolol in asthmatic patients. Br J Clin Pharmacol 1984; 17 Suppl. 1: 59S–64S

    PubMed  Google Scholar 

  99. Kelly JG, Shanks RG, McDevitt DG. Influence of ranitidine on plasma metoprolol concentrations. BMJ 1983; 287: 1218–9

    Google Scholar 

  100. Kelly JG, Salem SAM, Kinney CD, et al. Effects of ranitidine on the disposition of metoprolol. Br J Clin Pharmacol 1985; 19: 219–24

    PubMed  CAS  Google Scholar 

  101. Kirch W, Schafer-Korting M, Axthelm T, et al. Interaction of atenolol with furosemide and calcium and aluminium salts. Clin Pharmacol Ther 1981; 30(4): 429–35

    PubMed  CAS  Google Scholar 

  102. Hawksworth GM, Dart AM, Chiang CS, et al. Effect of oxprenolol on the pharmacokinetics and pharmacodynamics of hydralazine. Drugs 1983; 25 Suppl. 2: 136–40

    Google Scholar 

  103. Frishman WH, Oka Y, Strom JA, et al.β-Adrenoceptor blockade and coronary artery surgery. In: Frishman WH, editor. Clinical pharmacology of the β-adrenoceptor blocking drugs. 2 ed. Norwalk, Conn.: Appleton-Century-Crofts, 1984: 367–90

    Google Scholar 

  104. Roberts JG. Beta-adrenergic blockade and anaesthesia with reference to interactions with anaesthetic drugs and techniques. Anaesth Intensive Care 1980; 8(3): 318–35

    PubMed  CAS  Google Scholar 

  105. Pool JL, Shear CL, Downton M, et al. Lovastatin and coadministered antihypertensive/cardiovascular agents. Hypertension 1992; 19: 242–8

    PubMed  CAS  Google Scholar 

  106. Pan HY, Triscari J, DeVault AR, et al. Pharmacokinetic interaction between propranolol and the HMG-CoA reductase inhibitors pravastatin and lovastatin. Br J Clin Pharmacol 1991; 31: 665–70

    PubMed  CAS  Google Scholar 

  107. Ahokas JT, Davies C, Ravenscroft PJ. The effect of propranolol and atenolol on in vitro drug metabolism. IRCS Med Sci Biochem. 1982; 10(12): 984–5

    CAS  Google Scholar 

  108. Mantero F, Procidano M, Vicariotto MA, et al. Effect of atenolol and metoprolol on the anticoagulant activity of acenocoumarin. Br J Clin Pharmacol 1984; 17 Suppl.: 94S–96S

    PubMed  Google Scholar 

  109. Bax NDS, Lennard MS, Tucker GT, et al. The effect of betaadrenoceptor antagonists on the pharmacokinetics and pharmacodynamics of warfarin. Br J Clin Pharmacol 1984; 17 Suppl. 1: 85S

    PubMed  Google Scholar 

  110. Bax NDS, Lennard MS, Al-Asady S, et al. Inhibition of drug metabolism by beta-adrenoceptor antagonists. Drugs 1983: 25 Suppl. 2: 121–6

    CAS  Google Scholar 

  111. Scott AK, Park BK, Breckenridge AM. Interaction between warfarin and propranolol. Br J Clin Pharmacol 1984; 17 Suppl. 1: 86S

    PubMed  Google Scholar 

  112. Neilson GH, Seldon WA. Propranolol in angina pectoris. Med J Aust 1969; 1: 856–7

    PubMed  CAS  Google Scholar 

  113. Mignet JP, Mavier P, Soussy CJ, et al. Induction of hepatic microsomal enzymes after brief administration of rifampicin in man. Gastroenterology 1977; 72: 924–6

    Google Scholar 

  114. Bennett PN, John VA, Whitmarsh VB. Effect of rifampicin on metoprolol and antipyrine kinetics. Br J Clin Pharmacol 1982; 13: 387–91

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, The Albert Einstein College of Medicine, Bronx, New York, USA

    Ira Blaufarb, Tracy M. Pfeifer &  William H. Frishman

Authors
  1. Ira Blaufarb
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tracy M. Pfeifer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William H. Frishman
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blaufarb, I., Pfeifer, T.M. & Frishman, W.H. β-Blockers. Drug-Safety 13, 359–370 (1995). https://doi.org/10.2165/00002018-199513060-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002018-199513060-00005

Keywords

Search

Navigation