Moderate
Bisoprolol × Iopromide
Selective beta-adrenergic blockers×X-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agents
Mechanism
Beta-blockers can make treating anaphylaxis to iodinated contrast harder – adrenaline becomes less effective due to β-blockade.
Symptoms
On anaphylaxis: resistance to standard adrenaline dose – persistent hypotension, facial and tongue swelling, bronchospasm.
Management
The beta-blocker is usually not stopped for a contrast study. Prepare higher adrenaline doses and glucagon (3–5 mg IV for refractory anaphylaxis). In patients with allergy history, consider premedication (methylprednisolone + antihistamine).
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.