Affiliation:
1. Dubai Health Authority, P.O. Box: 4545, Dubai, United Arab Emirates
2. Department of Pharmacology, J.K.K. Nattraja College of Pharmacy, Komarapalayam 638 183, India
3. Department of Pharmaceutics, Faculty of Pharmacy, Elmergib University, Alkhoms, Libya
Abstract
Adrenergic β-blockers are used to treat many conditions, including hypertension, cardiac arrhythmias,
heart failure, angina pectoris, migraine, and tremors. The majority of the β-blockers including Propranolol, Metoprolol,
Acebutolol, Alprenolol, Betaxolol, Carvedilol, Nebivolol and Oxprenolol are metabolised majorly by
CYP2D6, and Bisoprolol is primarily metabolised by CYP3A4 enzymes. The drugs inhibiting or inducing them may
alter the pharmacokinetics of those β-blockers. The plasma concentrations of Propranolol might be elevated by the
concomitant use of drugs, such as SSRIs (Fluoxetine, Paroxetine), SNRIs (Duloxetine) and Cimetidine, while the
plasma concentrations of Metoprolol increased by the concurrent use of SSRIs (Fluoxetine, Paroxetine), Amiodarone,
Celecoxib, Cimetidine, Terbinafine, and Diphenhydramine. β-blockers can also interact pharmacodynamically
with drugs, including fluoroquinolones, antidiabetic agents and NSAIDs. In addition, β-blockers may interact with
herbs, such as curcumin, Ginkgo biloba, Schisandra chinensis, green tea, guggul, hawthorn, St. John’s wort and
Yohimbine. This article focuses on clinically relevant drug interactions of β-blockers with commonly prescribed
medications. In addition to Pharmacokinetics and Pharmacodynamics of the drug interactions, recommendations for
clinical practice are highlighted. The prescribers and the pharmacists are needed to be aware of the drugs interacting
with β-blockers to prevent possible adverse drug interactions.
Publisher
Bentham Science Publishers Ltd.
Subject
Clinical Biochemistry,Pharmacology