Beta-2 Agonists/Non-Cardioselective Beta-Blockers Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Your blood pressure/heart medicine and your lung medicine may cancel the effects of each other.

What might happen:

Neither medicine may work as well as expected.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know if your inhaler doesn't work as well or you notice you need a rescue inhaler more often. Let your doctor know if you have any changes in heart rate or blood pressure. Your doctor may want to change your medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.van der Woude HJ, Zaagsma J, Postma DS, Winter TH, van Hulst M, Aalbers R. Detrimental effects of beta-blockers in COPD: a concern for nonselective beta-blockers. Chest 2005 Mar;127(3):818-24.
  • 2.Hanania NA, Mannava B, Franklin AE, Lipworth BJ, Williamson PA, Garner WJ, Dickey BF, Bond RA. Response to salbutamol in patients with mild asthma treated with nadolol. Eur Respir J 2010 Oct;36(4):963-5.
  • 3.Warren JB, Monaghan AT, Clark TJ. Effect of penbutolol and propranolol on normal airway response to salbutamol. Clin Pharmacol Ther 1984 Jul; 36(1):47-50.
  • 4.Chodosh S, Tuck J, Blasucci DJ. The effects of dilevalol, metoprolol, and placebo on ventilatory function in asthmatics. J Cardiovasc Pharmacol 1988;11 Suppl 2:S18-24.
  • 5.Sheppard D, DiStefano S, Byrd RC, Eschenbacher WL, Bell V, Steck J, Laddu A. Effects of esmolol on airway function in patients with asthma. J Clin Pharmacol 1986 Mar;26(3):169-74.
  • 6.Falliers CJ, Vincent ME, Medakovic M. Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol. J Asthma 1986;23(5):251-60.
  • 7.Johnsson G, Svedmyr N, Thiringer G. Effects of intravenous propranolol and metoprolol and their interaction with isoprenaline on pulmonary function, heart rate and blood pressure in asthmatics. Eur J Clin Pharmacol 1975 Apr 4;8(3-4):175-80.
  • 8.Tafreshi MJ, Weinacker AB. Beta-adrenergic-blocking agents in bronchospastic diseases: a therapeutic dilemma. Pharmacotherapy 1999 Aug; 19(8):974-8.
  • 9.Chafin CC, Soberman JE, Demirkan K, Self T. Beta-blockers after myocardial infarction: do benefits ever outweigh risks in asthma?. Cardiology 1999; 92(2):99-105.
  • 10.Salpeter SR, Ormiston TM, Salpeter EE, Poole PJ, Cates CJ. Cardioselective beta-blockers for chronic obstructive pulmonary disease: a meta-analysis. Respir Med 2003 Oct;97(10):1094-101.
  • 11.Cazzola M, Noschese P, D'Amato M, D'Amato G. Comparison of the effects of single oral doses of nebivolol and celiprolol on airways in patients with mild asthma. Chest 2000 Nov;118(5):1322-6.
  • 12.Mue S, Sasaki T, Shibahara S, Takahashi M, Ohmi T, Yamauchi K, Suzuki S, Hida W, Takishima T. Influence of metoprolol on hemodynamics and respiratory function in asthmatic patients. Int J Clin Pharmacol Biopharm 1979 Aug;17(8):346-50.
  • 13.Lammers JW, Folgering HT, van Herwaarden CL. Respiratory tolerance of bisoprolol and metoprolol in asthmatic patients. J Cardiovasc Pharmacol 1986;8 Suppl 11:S69-73.
  • 14.Greefhorst AP, van Herwaarden CL. Comparative study of the ventilatory effects of three beta 1-selective blocking agents in asthmatic patients. Eur J Clin Pharmacol 1981;20(6):417-21.
  • 15.Boye NP, Vale JR. Effect in bronchial asthma of a new beta-adrenergic blocking drug atenolol (ICI 66, 082). Eur J Clin Pharmacol 1977; 11(1):11-4.
  • 16.Fogari R, Zoppi A, Tettamanti F, Poletti L, Rizzardi G, Fiocchi G. Comparative effects of celiprolol, propranolol, oxprenolol, and atenolol on respiratory function in hypertensive patients with chronic obstructive lung disease. Cardiovasc Drugs Ther 1990 Aug;4(4):1145-9.
  • 17.Ellis ME, Sahay JN, Chatterjee SS, Cruickshank JM, Ellis SH. Cardioselectivity of atenolol in asthmatic patients. Eur J Clin Pharmacol 1981;21(3):173-6.
  • 18.Doshan HD, Rosenthal RR, Brown R, Slutsky A, Applin WJ, Caruso FS. Celiprolol, atenolol and propranolol: a comparison of pulmonary effects in asthmatic patients. J Cardiovasc Pharmacol 1986;8 Suppl 4:S105-8.
  • 19.Matthys H, Doshan HD, Ruhle KH, Braig H, Pohl M, Applin WJ, Caruso FS, Neiss ES. The bronchosparing effect of celiprolol, a new beta 1- alpha 2-receptor antagonist on pulmonary function of propranolol-sensitive asthmatics. J Clin Pharmacol 1985 Jul-Aug;25(5):354-9.
  • 20.Brooks TW, Creekmore FM, Young DC, Asche CV, Oberg B, Samuelson WM. Rates of hospitalizations and emergency department visits in patients with asthma and chronic obstructive pulmonary disease taking beta-blockers. Pharmacotherapy 2007 May;27(5):684-90.
  • 21.Boskabady MH, Snashall PD. Bronchial responsiveness to beta-adrenergic stimulation and enhanced beta-blockade in asthma. Respirology 2000 Jun; 5(2):111-8.
  • 22.Patakas D, Argiropoulou V, Louridas G, Tsara V. Beta-blockers in bronchial asthma: effect of propranolol and pindolol on large and small airways. Thorax 1983 Feb;38(2):108-12.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.