Drug General Information (ID: DDI8L50FW1)
  Drug Name Digitoxin Drug Info Nebivolol Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antiarrhythmic Agents Antihypertensive Agents
  Structure

 Mechanism of Digitoxin-Nebivolol Interaction (Severity Level: Moderate)
     Increased risk of bradycardia Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Digitoxin Nebivolol
      Mechanism Bradycardia Bradycardia
      Key Mechanism Factor 1
Factor Name Bradycardia
Factor Description Bradycardia is a slow heart rate in which the heart beats less than 60 times per minute. If the heart rate is very slow and the heart is not pumping enough oxygen-rich blood to the body, and you may feel dizzy, very tired or weak, and short of breath.
      Mechanism Description
  • Increased risk of bradycardia by the combination of Digitoxin and Nebivolol 

Recommended Action
      Management Caution is advised during coadministration of digitalis glycosides and beta-blockers. Serum digitalis levels, heart rate, and blood pressure should be monitored closely, particularly during the first few weeks of concomitant therapy. Patients should be advised to notify their physician if they experience anorexia, nausea, visual changes, irregular heartbeat, slow pulse, dizziness, or syncope. Beta-blockers should not be used in patients with overt or decompensated congestive heart failure, as sympathetic stimulation may be a vital component in maintaining hemodynamic function in these patients and its inhibition by beta blockade may worsen the heart failure.

References
1 Watt DA "Sensitivity to propranolol after digoxin intoxication." Br Med J 2 (1968): 413-4
2 Lowenthal DT, Porter RS, Saris SD, Bies CM, Slegowski MB, Staudacher A "Clinical pharmacology, pharmacodynamics and interactions with esmolol." Am J Cardiol 56 (1985): f14-8
3 Product Information. Zebeta (bisoprolol). Lederle Laboratories, Wayne, NJ.