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Beta-Adrenergic Blockers

Also indexed as: Betagan, Brevibloc®, Carteolol, Cartrol®, Esmolol, Levatol®, Levobunolol, Metipranolol, Nebivolol, Ocupress®, OptiPranolol, Oxprenolol, Penbutolol, Pindolol, Visken®

Beta-adrenergic blockers or “beta blockers” are a family of drugs used to treat high blood pressure, angina, heart arrhythmia, tremors, alcohol withdrawal, glaucoma, and other conditions. They are also used to prevent migraine headaches, stage fright, and second heart attacks.

Interactions that are common to all beta-adrenergic blockers are described below. For interactions involving a specific beta-adrenergic blocker, refer to the highlighted drugs listed below.

Oral forms

Ophthalmic forms

Interactions with Dietary Supplements

Potassium
Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,1 leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.2 People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Interactions with Herbs

Pleurisy root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as beta-blockers.3

Summary of Interactions for Beta-Adrenergic Blockers

Depletion or interference None known
Adverse interaction High-potassium foods
Pleurisy root
Potassium supplements
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known
Interactions common to many, if not all, Beta-Adrenergic Blockers are described in this article. Interactions reported for only one or several drugs in this class may not be listed in this article. Some drugs listed in this article are linked to articles specific to that respective drug; please refer to those individual drug articles. The information in this article may not necessarily apply to drugs in this class for which no separate article exists. If you are taking a Beta-Adrenergic Blocker for which no separate article exists, talk with your doctor or pharmacist.

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal potassium disposal. N Engl J Med 1980;302:431–4.

2. Lundborg P. The effect of adrenergic blockade on potassium concentrations in different conditions. Acta Med Scand Suppl 1983;672:121–6 [review].

3. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213–4.