Interactions

Drug-Drug

• Drugs that affect the CYP2D6 enzyme system are expected to alter levels and possibly effects of nebivolol; dose alterations may be required.

• Fluoxetine, a known inhibitor of CYP2D6, levels and effects; similar effects may be expected from quinidine, propafenone, and paroxetine

• Blood levels are also by cimetine

• Anesthetic agents including ether, trichloroethylene, and cyclopropane as well as other myocardial depressants or inhibitors of AV conduction such as diltiazem and verapamil may risk of myocardial depression and bradycardia

• Avoid concurrent use with beta blockers

• Concurrent use with reserpine or guanethidine may excessively reduce sympathetic activity

• If used concurrently with clonidine, nebivolol should be tapered and discontinued several days prior to gradual withdrawal of clonidine

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