Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
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 (198)
- 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.
- etrasimod
etrasimod, pindolol. pharmacodynamic synergism. Use Caution/Monitor. Transient decrease in heart rate and AV conduction delays may occur when initiating etrasimod. Concomitant use of etrasimod in patients receiving stable beta-blocker treatment did not result in additive effects on heart rate reduction. However, risk of additive heart rate reduction following initiation of beta-blocker therapy with stable etrasimod treatment or concomitant use with other drugs that may decrease heart rate is unknown. .
- 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 topical
pindolol increases effects of cocaine topical 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.
- isavuconazonium sulfate
isavuconazonium sulfate will increase the level or effect of pindolol by Other (see comment). Minor/Significance Unknown. Isavuconazonium sulfate, an OCT2 inhibitor, may increase the effects or levels of OCT2 substrates.
- levobetaxolol
levobetaxolol increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.
- maitake
maitake increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.
- 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.
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
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
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.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%)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| pindolol oral - | 10 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 |  | |
| pindolol oral - | 5 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
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, your doctor 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 as directed by your doctor, usually twice daily.The dosage is based on your medical condition and response to treatment. 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.Tell your doctor if your condition lasts or gets worse (for example, if your routine blood pressure readings increase).
SIDE EFFECTS: Dizziness, weakness, and nausea may occur as your body adjusts to the medication. If any of these effects last or get worse, tell 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.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor 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 (such as 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 (such as 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 (such as anaphylaxis), breathing problems (such as asthma, chronic obstructive lung disease-COPD, emphysema, chronic bronchitis), blood circulation problems (such as Raynaud's disease, peripheral vascular disease), low blood flow to the heart/brain (such as due to coronary artery disease, stroke, transient ischemic attack), diabetes, heart problems (such as heart failure, heart attack, slow heartbeat), kidney disease, liver disease, mental/mood disorders (such as depression), a certain muscle problem (myasthenia gravis), overactive thyroid (hyperthyroidism), a certain type of tumor (pheochromocytoma).This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. 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).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).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.This product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). The risk is higher if you have diabetes, or are vomiting, fasting, or not eating regularly. Other symptoms of low blood sugar level, such as dizziness and sweating, are not affected by this drug.If you have diabetes, this product may make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Older adults may be at greater risk for side effects (such as dizziness) while using this drug.During pregnancy, this medication should be used only when clearly needed. 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: clonidine, epinephrine, fingolimod, thioridazine.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.Lab and/or medical tests (such as blood pressure, liver function) should be done while you are taking this medication. Keep all medical and lab appointments. 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 October 2023. Copyright(c) 2023 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.
Formulary
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.
