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Interacting Drugs

OBJECT DRUGS

Cholinesterase Inhibitors:

PRECIPITANT DRUGS

Beta-Blockers:


Comment:

Cholinesterase inhibitors increase vagal tone, which tends to slow the heart rate. When they are given with other drugs that slow heart rate such as beta-blockers, excessive bradycardia can result. In some cases the combination of cholinesterase inhibitors and bradycardic drugs has been associated with life-threatening reactions, with severe bradycardia, cardiac arrhythmias, and even cardiac arrest. More study is needed to establish the incidence and magnitude of these interactions, but the potential severity of the reactions dictates that the combinations should be used only with close monitoring.


Class 2: Use Only if Benefit Felt to Outweigh Risk