Moderate
Bisoprolol × Dronedarone
Selective beta-adrenergic blockers×Class III antiarrhythmic
Mechanism
Additive bradycardia. Dronedarone itself causes bradycardia via β-receptor blockade and AV node suppression. The combination increases symptomatic bradycardia and AV block risk.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk. With additional antihypertensives: bradycardia (pulse below 60/min).
Management
When dronedarone starts, reduce bisoprolol by 25%. Check pulse and ECG at 1 and 4 weeks. If pulse drops below 50 or second-degree AV block appears, adjust further.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.