ModerateSelective beta-adrenergic blockers×Other antidepressants (NDRI)
Updated · Methodology
Mechanism
Bupropion blocks CYP2D6. Bisoprolol is metabolised 50% via CYP3A4 and 50% renally, so the effect is clinically minor, unlike metoprolol (fully CYP2D6).
Symptoms
Minimal changes: mild additional bradycardia possible. Older patients: rare symptomatic hypotension.
Management
Dose adjustment is usually unnecessary. In older patients and reduced ejection fraction, check pulse and blood pressure 2 weeks after start.
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Sources
- FDA: Bisoprolol tablet (Micro Labs Limited) – Prescribing Information (2016)– ; DailyMed setid c3ee566c-74c4-45f4-a947-526a7313e326
- AEMPS: Ficha técnica: Bupropión (nº registro 88175), sección 4.5 (2026)– AEMPS, CIMA, nº registro 88175, revisión 03/2026, sección 4.5