BETA-BLOCKERS - DRUG-INTERACTIONS OF CLINICAL-SIGNIFICANCE

The clinician prescribing beta-blockers for his or her patients is fac ed with an often difficult situation. There are many beta-blockers, ea ch with its own pharmacological profile. Patients are often taking mul tiple medications, thus increasing the risk of both anticipated and un expected drug interactions. Reports of drug interactions are frequentl y anecdotal. The prescriber may not be aware of the patient's other me dications or lifestyle habits. Pharmacokinetic and pharmacodynamic dru g interactions involving beta-blockers are documented in the literatur e, but these studies often examine small numbers of patients. For thes e reasons, it is difficult for the practitioner to distill guidelines for the administration of beta-blockers in conjunction with other medi cation. In general, beta-blockers are well tolerated, and symptomatic drug interactions are relatively infrequent. It is incumbent upon the clinical practitioner to have knowledge of his or her patient's drug p rofile and to be aware of the various drug interactions as well as eac h patient's unique pathophysiological profile when prescribing any med ication, including beta-blockers. beta-Blockers may interact with a la rge number of commonly prescribed drugs, including antihypertensive an d antianginal drugs, inotropic agents, antiarrhythmics, NSAIDs, psycho tropic drugs, anti-ulcer medications, anaesthetics, HMG-CoA reductase inhibitors, warfarin, oral hypoglycaemics and rifampicin (rifampin).