MajorAlpha and beta blocker (non-selective β + α1)×Methylxanthine
Updated · Methodology
Mechanism
Carvedilol blocks β2-adrenergic receptors (non-selective beta-blocker) and causes bronchoconstriction in asthma or COPD. Theophylline becomes less effective in these conditions.
Symptoms
Recurrence of asthma or COPD symptoms: dyspnoea, wheezing, need for additional short-acting β2-agonist doses. In severe asthma: risk of severe bronchospasm.
Management
Avoid the combination in asthma and severe COPD. In heart failure with mild COPD, a selective beta-blocker (bisoprolol, metoprolol) is preferred. Alternative to theophylline: long-acting inhaled β2-agonists with anticholinergics.
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.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- ESC: ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2021)– McDonagh TA et al. Eur Heart J 2021;42:3599-3726