pindolol (Rx)

Brand and Other Names:Visken
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablets

  • 5mg
  • 10mg

Hypertension

5 mg PO q12hr initially; may increase by 10 mg/day q3-4wk to up to 30 mg PO q12hr

Chronic Stable Angina (Off-label)

15-40 mg/day PO divided q6-8hr

Renal Impairment

Use caution; may consider dose reduction

Hepatic Impairment

Use caution; in severe impairment dose reduction may be necessary

Safety & efficacy not established

5 mg PO q12hr initially; may increase by 5 mg/day q3-4wk

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Interactions

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              Serious - Use Alternative (23)

              • acebutolol

                acebutolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • atenolol

                atenolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • betaxolol

                betaxolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • bisoprolol

                bisoprolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • carvedilol

                carvedilol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • celiprolol

                celiprolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • epinephrine

                pindolol increases effects of epinephrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).

              • epinephrine racemic

                pindolol increases effects of epinephrine racemic by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).

              • esmolol

                esmolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • givosiran

                givosiran will increase the level or effect of pindolol by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.

              • labetalol

                labetalol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • lofexidine

                lofexidine, pindolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              • metoprolol

                metoprolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • nadolol

                nadolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • nebivolol

                nebivolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • penbutolol

                penbutolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • propranolol

                pindolol and propranolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • sotalol

                pindolol and sotalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • tafenoquine

                tafenoquine will increase the level or effect of pindolol by Other (see comment). Avoid or Use Alternate Drug. Tafenoquine inhibits organic cation transporter-2 (OCT2) and multidrug and toxin extrusion (MATE) transporters in vitro. Avoid coadministration with OCT2 or MATE substrates. If coadministration cannot be avoided, monitor for substrate-related toxicities and consider dosage reduction if needed based on product labeling of the coadministered drug.

              • timolol

                pindolol and timolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • trilaciclib

                trilaciclib will decrease the level or effect of pindolol by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of trilaciclib (OCT2, MATE1, and MATE-2K inhibitor) with substrates where minimal increased concentration in kidney or blood may lead to serious or life-threatening toxicities.

              • umeclidinium bromide/vilanterol inhaled

                pindolol, umeclidinium bromide/vilanterol inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .

              • vilanterol/fluticasone furoate inhaled

                pindolol, vilanterol/fluticasone furoate inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .

              Monitor Closely (197)

              • abiraterone

                abiraterone increases levels of pindolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.

              • acebutolol

                acebutolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • aceclofenac

                pindolol and aceclofenac both increase serum potassium. Use Caution/Monitor.

                aceclofenac decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • acemetacin

                pindolol and acemetacin both increase serum potassium. Use Caution/Monitor.

                acemetacin decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • albuterol

                pindolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • aldesleukin

                aldesleukin increases effects of pindolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • alfuzosin

                alfuzosin and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • aluminum hydroxide

                aluminum hydroxide decreases levels of pindolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • amifostine

                amifostine, pindolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

              • amiloride

                pindolol and amiloride both increase serum potassium. Modify Therapy/Monitor Closely.

              • amiodarone

                amiodarone, pindolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of cardiotoxicity with bradycardia.

              • amlodipine

                pindolol and amlodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • amobarbital

                amobarbital decreases levels of pindolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of amobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • arformoterol

                pindolol increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of arformoterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • articaine

                pindolol, articaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Increased effects of epinephrine in anesthetic; risk of hypertension and bradycardia. Do NOT D/C chronic beta blocker Tx prior to anesthetic administration. Consider selective beta 1 blocker (e.g., metoprolol).

              • asenapine

                asenapine and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • aspirin

                pindolol and aspirin both increase serum potassium. Use Caution/Monitor.

                aspirin decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • aspirin rectal

                pindolol and aspirin rectal both increase serum potassium. Use Caution/Monitor.

                aspirin rectal decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                pindolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.

              • atazanavir

                atazanavir increases effects of pindolol by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension, bradycardia, AV block, and prolonged PR interval. Consider lowering beta blocker dose.

              • atenolol

                atenolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • bendroflumethiazide

                pindolol increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • betaxolol

                betaxolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • bismuth subsalicylate

                bismuth subsalicylate, pindolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Blockage of renal prostaglandin synthesis; may cause severe hypertension.

              • bisoprolol

                bisoprolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • bumetanide

                pindolol increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • bupivacaine

                pindolol, bupivacaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.

              • butabarbital

                butabarbital decreases levels of pindolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butabarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • butalbital

                butalbital decreases levels of pindolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butalbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • calcium acetate

                calcium acetate decreases effects of pindolol by unspecified interaction mechanism. Use Caution/Monitor.

              • calcium carbonate

                calcium carbonate decreases effects of pindolol by unspecified interaction mechanism. Use Caution/Monitor.

                calcium carbonate decreases levels of pindolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • calcium chloride

                calcium chloride decreases effects of pindolol by unspecified interaction mechanism. Use Caution/Monitor.

              • calcium citrate

                calcium citrate decreases effects of pindolol by unspecified interaction mechanism. Use Caution/Monitor.

              • calcium gluconate

                calcium gluconate decreases effects of pindolol by unspecified interaction mechanism. Use Caution/Monitor.

              • candesartan

                candesartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, candesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • carbenoxolone

                pindolol increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carbidopa

                carbidopa increases effects of pindolol by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.

              • carvedilol

                carvedilol and pindolol both increase serum potassium. Use Caution/Monitor.

              • celecoxib

                pindolol and celecoxib both increase serum potassium. Use Caution/Monitor.

                celecoxib decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • celiprolol

                celiprolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • chloroprocaine

                pindolol, chloroprocaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Increased effects of epinephrine in anesthetic; risk of hypertension and bradycardia. Do NOT D/C chronic beta blocker Tx prior to anesthetic administration. Consider selective beta 1 blocker (e.g., metoprolol).

              • chlorothiazide

                pindolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorpropamide

                pindolol decreases effects of chlorpropamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • chlorthalidone

                pindolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • choline magnesium trisalicylate

                pindolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

                choline magnesium trisalicylate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • clevidipine

                pindolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • clonidine

                pindolol, clonidine. Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Non selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.

              • cyclopenthiazide

                pindolol increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dasiglucagon

                pindolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.

              • desflurane

                desflurane, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • diclofenac

                pindolol and diclofenac both increase serum potassium. Use Caution/Monitor.

                diclofenac decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • diflunisal

                pindolol and diflunisal both increase serum potassium. Use Caution/Monitor.

                diflunisal decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • digoxin

                pindolol and digoxin both increase serum potassium. Use Caution/Monitor.

                pindolol increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Enhanced bradycardia.

              • diltiazem

                pindolol and diltiazem both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • dobutamine

                pindolol increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of dobutamine by pharmacodynamic antagonism. Use Caution/Monitor.

              • dopexamine

                pindolol increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of dopexamine by pharmacodynamic antagonism. Use Caution/Monitor.

              • doxazosin

                doxazosin and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • drospirenone

                pindolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.

              • eliglustat

                eliglustat increases levels of pindolol by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of pindolol by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

              • ephedrine

                pindolol increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of ephedrine by pharmacodynamic antagonism. Use Caution/Monitor.

              • epinephrine

                pindolol increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor.

              • epinephrine racemic

                pindolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

              • eprosartan

                eprosartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, eprosartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • erdafitinib

                erdafitinib increases levels of pindolol by decreasing renal clearance. Modify Therapy/Monitor Closely. Consider alternatives that are not OCT2 substrates or consider reducing the dose of OCT2 substrates based on tolerability.

              • esmolol

                esmolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • ethacrynic acid

                pindolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ether

                pindolol, ether. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both beta blockers and ether depress the myocardium; consider lowering beta blocker dose if ether used for anesthesia.

              • etodolac

                pindolol and etodolac both increase serum potassium. Use Caution/Monitor.

                etodolac decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • etomidate

                etomidate, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • felodipine

                pindolol and felodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • fenbufen

                pindolol and fenbufen both increase serum potassium. Use Caution/Monitor.

              • fenoprofen

                pindolol and fenoprofen both increase serum potassium. Use Caution/Monitor.

                fenoprofen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • fingolimod

                pindolol increases effects of fingolimod by pharmacodynamic synergism. Use Caution/Monitor. Both medications decrease heart rate. Monitor patients on concomitant therapy, particularly in the first 6 hours after fingolimod is initiated or after a treatment interruption of at least two weeks, for bradycardia and atrioventricular block. To identify underlying risk factors of bradycardia and AV block, obtain a new or recent ECG in patients using beta-blockers prior to starting fingolimod.

              • flurbiprofen

                pindolol and flurbiprofen both increase serum potassium. Use Caution/Monitor.

                flurbiprofen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • formoterol

                pindolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • furosemide

                pindolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • gentamicin

                pindolol increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • glimepiride

                pindolol decreases effects of glimepiride by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • glipizide

                pindolol decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • glucagon

                glucagon decreases toxicity of pindolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.

              • glucagon intranasal

                glucagon intranasal decreases toxicity of pindolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.

              • glyburide

                pindolol decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • guanfacine

                pindolol, guanfacine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.

              • hydralazine

                hydralazine increases effects of pindolol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects.

              • hydrochlorothiazide

                pindolol increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ibuprofen

                pindolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

                ibuprofen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ibuprofen IV

                ibuprofen IV decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                pindolol and ibuprofen IV both increase serum potassium. Use Caution/Monitor.

              • indacaterol, inhaled

                indacaterol, inhaled, pindolol. Other (see comment). Use Caution/Monitor. Comment: Beta-blockers and indacaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.

              • indapamide

                pindolol increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • indomethacin

                pindolol and indomethacin both increase serum potassium. Use Caution/Monitor.

                indomethacin decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • insulin aspart

                pindolol, insulin aspart. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

              • insulin degludec

                pindolol, insulin degludec. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).

              • insulin degludec/insulin aspart

                pindolol, insulin degludec/insulin aspart. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).

              • insulin detemir

                pindolol, insulin detemir. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

              • insulin glargine

                pindolol, insulin glargine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

              • insulin glulisine

                pindolol, insulin glulisine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

              • insulin inhaled

                pindolol, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).

              • insulin lispro

                pindolol, insulin lispro. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

              • insulin NPH

                pindolol, insulin NPH. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

              • insulin regular human

                pindolol, insulin regular human. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

              • iodixanol

                pindolol increases toxicity of iodixanol by unspecified interaction mechanism. Use Caution/Monitor. Use of beta-blockers lowers the threshold for and increases the severity of contrast reactions, and reduces the responsiveness of treatment of hypersensitivity reactions with epinephrine. .

              • irbesartan

                irbesartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, irbesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • isoproterenol

                pindolol increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of isoproterenol by pharmacodynamic antagonism. Use Caution/Monitor.

              • isradipine

                pindolol and isradipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • ivabradine

                ivabradine, pindolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Most patients receiving ivabradine will also be treated with a beta-blocker. The risk of bradycardia increases with coadministration of drugs that slow heart rate (eg, digoxin, amiodarone, beta-blockers). Monitor heart rate in patients taking ivabradine with other negative chronotropes.

              • ketamine

                ketamine, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • ketoprofen

                pindolol and ketoprofen both increase serum potassium. Use Caution/Monitor.

                ketoprofen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ketorolac

                pindolol and ketorolac both increase serum potassium. Use Caution/Monitor.

                ketorolac decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ketorolac intranasal

                pindolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.

                ketorolac intranasal decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • labetalol

                labetalol and pindolol both increase serum potassium. Use Caution/Monitor.

              • lasmiditan

                pindolol increases effects of lasmiditan by pharmacodynamic synergism. Use Caution/Monitor. Lasmiditan has been associated with a lowering of heart rate (HR). In a drug interaction study, addition of a single 200-mg dose of lasmiditan to propranolol decreased HR by an additional 5 bpm compared to propranolol alone, for a mean maximum of 19 bpm.

              • levalbuterol

                pindolol increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of levalbuterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • levodopa

                levodopa increases effects of pindolol by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.

              • lidocaine

                pindolol, lidocaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Increased effects of epinephrine in anesthetic; risk of hypertension and bradycardia. Do NOT D/C chronic beta blocker Tx prior to anesthetic administration. Consider selective beta 1 blocker (e.g., metoprolol).

                pindolol increases levels of lidocaine by decreasing elimination. Use Caution/Monitor. Risk of hypertension and bradycardia. Consider selective beta 1 blocker (e.g., metoprolol).

              • lorcaserin

                lorcaserin will increase the level or effect of pindolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              • lornoxicam

                pindolol and lornoxicam both increase serum potassium. Use Caution/Monitor.

                lornoxicam decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • losartan

                losartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, losartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • lurasidone

                lurasidone increases effects of pindolol by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

              • maraviroc

                maraviroc, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.

              • meclofenamate

                meclofenamate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                pindolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • mefenamic acid

                pindolol and mefenamic acid both increase serum potassium. Use Caution/Monitor.

                mefenamic acid decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • mefloquine

                mefloquine increases levels of pindolol by decreasing metabolism. Use Caution/Monitor. Risk of arrhythmia.

              • meloxicam

                pindolol and meloxicam both increase serum potassium. Use Caution/Monitor.

                meloxicam decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • mepivacaine

                pindolol, mepivacaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.

              • metaproterenol

                pindolol increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of metaproterenol by pharmacodynamic antagonism. Use Caution/Monitor.

              • methyclothiazide

                pindolol increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • methyldopa

                pindolol, methyldopa. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from methyldopa may result in rebound hypertension.

              • metolazone

                pindolol increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metoprolol

                metoprolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • mirabegron

                mirabegron will increase the level or effect of pindolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              • moxisylyte

                moxisylyte and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nabumetone

                pindolol and nabumetone both increase serum potassium. Use Caution/Monitor.

                nabumetone decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • nadolol

                nadolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • naproxen

                pindolol and naproxen both increase serum potassium. Use Caution/Monitor.

                naproxen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • nebivolol

                nebivolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • nicardipine

                pindolol and nicardipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nifedipine

                pindolol and nifedipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nisoldipine

                pindolol and nisoldipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nitroglycerin rectal

                nitroglycerin rectal, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers blunt the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If beta-blockers are used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur.

              • norepinephrine

                pindolol increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of norepinephrine by pharmacodynamic antagonism. Use Caution/Monitor.

              • olmesartan

                olmesartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, olmesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • olodaterol inhaled

                pindolol, olodaterol inhaled. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Beta-blockers and olodaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.

              • oxaprozin

                pindolol and oxaprozin both increase serum potassium. Use Caution/Monitor.

                oxaprozin decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • parecoxib

                pindolol and parecoxib both increase serum potassium. Use Caution/Monitor.

                parecoxib decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • penbutolol

                penbutolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • pentobarbital

                pentobarbital decreases levels of pindolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of pentobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • phenobarbital

                phenobarbital decreases levels of pindolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of phenobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • phenoxybenzamine

                phenoxybenzamine and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • phentolamine

                phentolamine and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • phenylephrine

                pindolol increases effects of phenylephrine by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode (rare).

              • phenylephrine PO

                pindolol increases effects of phenylephrine PO by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode (rare).

              • pirbuterol

                pindolol increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of pirbuterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • piroxicam

                pindolol and piroxicam both increase serum potassium. Use Caution/Monitor.

                piroxicam decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ponesimod

                ponesimod and pindolol both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Beta-blockers may have additive effects on lowering HR. Consider resting HR before initiating ponesimod in patients on stable dose of beta-blocker. Refer to the ponesimod prescribing information for more dosing information.

              • potassium acid phosphate

                pindolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.

              • potassium chloride

                pindolol and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.

              • potassium citrate

                pindolol and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.

              • prazosin

                prazosin and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • prilocaine

                pindolol, prilocaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.

              • primidone

                primidone decreases levels of pindolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of primidone. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • propofol

                propofol, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • propranolol

                pindolol and propranolol both increase serum potassium. Use Caution/Monitor.

              • ropivacaine

                pindolol, ropivacaine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use extreme caution during concomitant use of bupivacaine and antihypertensive agents.

              • sacubitril/valsartan

                sacubitril/valsartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, sacubitril/valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • salicylates (non-asa)

                pindolol and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.

                salicylates (non-asa) decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • salmeterol

                pindolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • salsalate

                pindolol and salsalate both increase serum potassium. Use Caution/Monitor.

                salsalate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • saquinavir

                saquinavir, pindolol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Use alternatives if available. Increased risk of PR prolongation and cardiac arrhythmias.

              • secobarbital

                secobarbital decreases levels of pindolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of secobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • sevoflurane

                sevoflurane, pindolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • sildenafil

                pindolol increases effects of sildenafil by additive vasodilation. Use Caution/Monitor. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy.

              • silodosin

                silodosin and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • siponimod

                siponimod, pindolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Caution when siponimod is initiated in patients receiving beta-blocker treatment because of additive effects on lowering heart rate. Temporary interruption of beta-blocker may be needed before initiating siponimod. Beta-blocker treatment can be initiated in patients receiving stable doses of siponimod.

              • sodium bicarbonate

                sodium bicarbonate decreases levels of pindolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • sodium citrate/citric acid

                sodium citrate/citric acid decreases levels of pindolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • sotalol

                pindolol and sotalol both increase serum potassium. Use Caution/Monitor.

              • spironolactone

                pindolol and spironolactone both increase serum potassium. Modify Therapy/Monitor Closely.

              • succinylcholine

                pindolol and succinylcholine both increase serum potassium. Use Caution/Monitor.

              • sulfasalazine

                pindolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.

                sulfasalazine decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • sulindac

                pindolol and sulindac both increase serum potassium. Use Caution/Monitor.

                sulindac decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • telmisartan

                telmisartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, telmisartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • terazosin

                terazosin and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • terbutaline

                pindolol increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                pindolol decreases effects of terbutaline by pharmacodynamic antagonism. Use Caution/Monitor.

              • theophylline

                pindolol, theophylline. Other (see comment). Use Caution/Monitor. Comment: Beta blockers (esp. non selective) antagonize theophylline effects, while at the same time increasing theophylline levels and toxicity (mechanism: decreased theophylline metabolism). Smoking increases risk of interaction.

              • timolol

                pindolol and timolol both increase serum potassium. Use Caution/Monitor.

              • tolazamide

                pindolol decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • tolbutamide

                pindolol decreases effects of tolbutamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • tolfenamic acid

                pindolol and tolfenamic acid both increase serum potassium. Use Caution/Monitor.

                tolfenamic acid decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • tolmetin

                pindolol and tolmetin both increase serum potassium. Use Caution/Monitor.

                tolmetin decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • tolvaptan

                pindolol and tolvaptan both increase serum potassium. Use Caution/Monitor.

              • torsemide

                pindolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • triamterene

                pindolol and triamterene both increase serum potassium. Modify Therapy/Monitor Closely.

              • valsartan

                valsartan and pindolol both increase serum potassium. Use Caution/Monitor.

                pindolol, valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • vandetanib

                vandetanib increases levels of pindolol by Other (see comment). Modify Therapy/Monitor Closely. Comment: Vandetanib inhibits the uptake of substrates of organic cation transporter type 2 (OCT2).

              • verapamil

                pindolol and verapamil both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • xipamide

                xipamide increases effects of pindolol by pharmacodynamic synergism. Use Caution/Monitor.

              Minor (29)

              • adenosine

                pindolol, adenosine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Bradycardia.

              • agrimony

                agrimony increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • brimonidine

                brimonidine increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • cevimeline

                cevimeline increases effects of pindolol by unspecified interaction mechanism. Minor/Significance Unknown.

              • ciprofloxacin

                ciprofloxacin increases levels of pindolol by decreasing metabolism. Minor/Significance Unknown.

              • cocaine

                pindolol increases effects of cocaine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of angina.

              • cornsilk

                cornsilk increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • dihydroergotamine

                dihydroergotamine, pindolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.

              • dihydroergotamine intranasal

                dihydroergotamine intranasal, pindolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.

              • dipyridamole

                dipyridamole, pindolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of bradycardia.

              • entecavir

                pindolol, entecavir. Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.

              • escitalopram

                escitalopram increases levels of pindolol by decreasing metabolism. Minor/Significance Unknown.

              • fenoldopam

                fenoldopam increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

              • forskolin

                forskolin increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • imaging agents (gadolinium)

                pindolol, imaging agents (gadolinium). Mechanism: unknown. Minor/Significance Unknown. Increased risk of anaphylaxis from contrast media.

              • levobetaxolol

                levobetaxolol increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • maitake

                maitake increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • melatonin

                melatonin decreases toxicity of pindolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

              • metipranolol ophthalmic

                metipranolol ophthalmic increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • neostigmine

                pindolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.

              • noni juice

                pindolol and noni juice both increase serum potassium. Minor/Significance Unknown.

              • octacosanol

                octacosanol increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • physostigmine

                pindolol, physostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.

              • pilocarpine

                pilocarpine increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • reishi

                reishi increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • shepherd's purse

                shepherd's purse, pindolol. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.

              • tizanidine

                tizanidine increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

              • treprostinil

                treprostinil increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • yohimbe

                pindolol decreases toxicity of yohimbe by pharmacodynamic antagonism. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Insomnia (10%)

              Muscle pain (10%)

              Dizziness (9%)

              Fatigue (8%)

              Nervousness (7%)

              Elevated liver enzymes (7%)

              Joint pain (7%)

              Edema (6%)

              Vivid dreams (5%),

              Abdominal discomfort (4-5%)

              Nausea (4-5%)

              Muscle cramps (3%)

              Paresthesias (3%)

              Bradycardia (2%)

              Cold extremities (2%)

              Hypotension (2%)

              Palpitations (2%)

              Syncope (2%)

              Tachycardia (2%)

              Anxiety (2%)

              Lethargy (2%)

              Diarrhea (2%)

              Vomiting (2%)

              Impotence/reduced libido (1-2%)

              Frequency Not Defined

              Heart failure

              Syncope

              Tachyarrythmia

              Bronchospasm, depression, decreased exercise tolerance, Raynaud's phenomenon

              May increase triglyceride levels and insulin resistance, and decrease HDL levels

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              Warnings

              Contraindications

              Overt heart failure, asthma/COPD, cardiogenic shock, hypersensitivity, sinus bradycardia, 2nd-3rd degree heart block, cardiogenic shock, sick sinus syndrome without permanent pacemaker

              Cautions

              Use caution in anesthesia/surgery (myocardial depression), bronchospastic disease, cerebrovascular insufficiency, CHF, cardiomegaly, DM, hyperthyroidism/thyrotoxicosis, myasthenia gravis, liver disease, renal impairment, peripheral vascular disease, use in pheochromocytoma, IDDM, history of psychiatric disease, pre-existing sick sinus syndrome or similar cardiac conditions

              Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery; the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures

              Sudden discontinuation can exacerbate angina and lead to myocardial infarction

              Less effective than thiazide diuretics in black and geriatric patients

              Increased risk of stroke after surgery

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              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: do not nurse

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Non-selective beta adrenergic receptor with mild sympathomimetic activity; has negative inotropic and chronotropic effects and can significantly slow AV nodal conduction.

              Pharmacokinetics

              Bioavailability: 50-95%

              Protein Bound: 40%

              Peak Plasma (single 20 mg dose) Concentration: 45-167 mcg/L

              Peak Plasma (single 20 mg dose) Time: 1 hr

              Vd: 1.2-2 L/kg

              Half-Life: 3-4 hr in healthy adults

              Metabolism: 60-65% in liver, primarily to hydroxy metabolites which are excreted as glucuronides & ethereal sulfates

              Clearance: Tubular secretion

              Excretion: Urine (35-40% as unchanged drug); feces (6-9%)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              pindolol oral
              -
              10 mg tablet
              pindolol oral
              -
              5 mg tablet
              pindolol oral
              -
              5 mg tablet
              pindolol oral
              -
              10 mg tablet
              pindolol oral
              -
              10 mg tablet
              pindolol oral
              -
              5 mg tablet
              pindolol oral
              -
              10 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              pindolol oral

              PINDOLOL - ORAL

              (PIN-doe-lol)

              COMMON BRAND NAME(S): Visken

              WARNING: Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, he or she may direct you to gradually decrease your dose over 1 to 2 weeks.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Get medical help right away if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.

              USES: This medication is used alone or with other medications to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems. Pindolol belongs to a class of medications called beta-blockers. It works by blocking the effects of certain natural substances (such as epinephrine) on the heart and blood vessels. This results in a lowering of the heart rate, blood pressure, and strain on the heart.

              HOW TO USE: See also Warning section.Take this medication by mouth with or without food, usually twice daily or as directed by your doctor.The dosage is based on your medical condition and response to therapy. It may take 1-2 weeks before the full benefit of this drug takes effect. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.Inform your doctor if your condition persists or worsens (for example, if your routine blood pressure readings increase).

              SIDE EFFECTS: Dizziness, drowsiness, weakness, and nausea may occur as your body adjusts to the medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Avoid tobacco use and dress warmly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), bluish color of the fingers/toes/nails, hair loss (reversible), mental/mood changes (e.g., confusion, depression, memory problems), pain/cramps in the muscles/joints, numbness/tingling, decreased sexual ability, vision changes, slow/irregular/fast heartbeat, severe dizziness/fainting.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking pindolol, tell your doctor or pharmacist if you are allergic to it; or to other beta-blockers (e.g., acebutolol); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe allergic reactions (e.g., anaphylaxis), breathing problems (e.g., asthma, chronic obstructive lung disease-COPD, emphysema, chronic bronchitis), blood circulation problems (e.g., Raynaud's disease, peripheral vascular disease), low blood flow to the heart/brain (e.g., due to coronary artery disease, stroke, transient ischemic attack), diabetes, heart problems (e.g., heart failure, heart attack, slow heartbeat), kidney disease, liver disease, mental/mood disorders (e.g., depression), a certain muscle problem (myasthenia gravis), overactive thyroid (hyperthyroidism), a certain type of tumor (pheochromocytoma).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.Before having surgery, tell your doctor or dentist that you are taking this medication.This drug may rarely make your blood sugar level rise, causing or worsening diabetes. Tell your doctor right away if you develop symptoms of high blood sugar such as increased thirst or frequent urination.If you have diabetes, this medication may mask the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of a low blood sugar level such as dizziness and sweating are unaffected by this drug.Kidney function declines as you grow older. This medication is removed by the kidneys and liver. Therefore, elderly people may be at greater risk for side effects such as dizziness while using this drug.This medication should be used only when clearly needed during pregnancy. It may harm an unborn baby. Discuss the risks and benefits with your doctor.This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: alpha-blockers (e.g., prazosin), arbutamine, other beta-blockers (e.g., atenolol), clonidine, epinephrine, fenoldopam, fingolimod, thioridazine, other drugs for high blood pressure (e.g., methyldopa), drugs affecting liver enzymes that remove this medication from your body (e.g., amiodarone, chlorpromazine, St. John's wort).Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very slow heartbeat, severe dizziness/fainting, slow/shallow breathing.

              NOTES: Do not share this medication with others. Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Have your blood pressure checked regularly while taking this medication. Discuss with your doctor how to monitor your own blood pressure and pulse.Laboratory and/or medical tests (e.g., blood pressure, liver tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised May 2020. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.