Bisoprolol and Vilanterol: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Bisoprolol
Vilanterol
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Decreased efficacy of vilanterol
Interaction Deep Dive
Concomitant use of vilanterol, a beta-2 agonist, and a beta-adrenergic receptor antagonist (beta blocker) may interfere with the efficacy of vilanterol due to pharmacological antagonism. Additionally, beta blockers may produce severe bronchospasm in patients with COPD or asthma. Therefore, use of beta blockers is usually not recommended in patients with COPD or asthma. If concomitant use is required or there are no acceptable alternatives, consider using a cardioselective beta blocker with caution1.
Why it happens (mechanism)
Pharmacological antagonism
Common questions
Can I take Bisoprolol and Vilanterol together?
Decreased efficacy of vilanterol Always confirm with your pharmacist or prescriber before making any change.
How serious is the Bisoprolol and Vilanterol interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Bisoprolol or Vilanterol need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: TRELEGY ELLIPTA inhalation powder, fluticasone furoate, umeclidinium, vilanterol inhalation powder. GlaxoSmithKline (per manufacturer), Research Triangle Park, NC, 2020. DailyMed
Keep reading about Bisoprolol
Keep reading about Vilanterol
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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