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Beta-Blockers - Interactions and Warnings

Continued administration of Beta-Blockers up to the time of anesthesia has been encouraged except in patients with signs of intolerance such as hypotension or excessive bradycardia.
- Can J Anaesth 2000 Jul;47(7):653-63 -- [Perioperative beta-blockers. Part one: fundamentals] -- Piriou V, Aouifi A, Lehot JJ.

Administration of cimetidine with timolol ophthalmic solution increased the degree of beta-blockade.
- J Clin Pharmacol 2000 Feb;40(2):193-9 -- Drug interaction between cimetidine and timolol ophthalmic solution: effect on heart rate and intraocular pressure in healthy Japanese volunteers. -- Ishii Y, Nakamura K, Tsutsumi K, Kotegawa T, Nakano S, Nakatsuka K.

Some beta-blockers may deplete levels of coenzyme Q10.
- Res Commun Chem Pathol Pharmacol 1977 May;17(1):157-64 -- Bioenergetics in clinical medicine XV. Inhibition of coenzyme Q10-enzymes by clinically used adrenergic blockers of beta-receptors. -- Kishi T, Watanabe T, Folkers K.

Prolonged ingestion of licorice is a well-known cause of hypertension due to hypermineralocorticoidism. We describe 2 cases of hypertension encephalopathy (in addition to the classical symptoms of hypertension, hypokalemia and suppression of the renin-aldosterone system) which resulted in pseudohyperaldosteronism syndrome due to the regular daily intake of low doses of licorice. Glycyrrhizic acid, a component of licorice, produces both hypermineralocorticism and the onset of encephalopathy. It is proposed that some people could be susceptible to low doses of glycyrrhizic acid.
- Am J Nephrol 2000 Mar-Apr;20(2):145-8 -- Low doses of liquorice can induce hypertension encephalopathy. -- Russo S, Mastropasqua M, Mosetti MA, Persegani C, Paggi A.

One of the ingredients in ma huang is ephedrine, an active alpha- and beta-adrenergic stimulant that produces increases in heart rate, blood pressure, and cardiac output. Ma huang has been reported to cause hypertension, hepatitis, nephrolithiasis, and sudden death in healthy, normotensive people.
- Mil Med 2002 Jun;167(6):521-3 -- A mysterious blood pressure increase in a drilling Naval reservist. -- Wettach GE, Falvey SG.

last update: November 2008

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