Deslanoside and Atenolol: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 15, 2026 · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Atenolol
Deslanoside
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.
Atenolol (a beta-blocker) and deslanoside (a digitalis heart medicine) both slow down your heart. Each one alone can lower your heart rate and calm the electrical signals that travel through your heart. When you take them together, that slowing can add up, so your heart rate may drop too low. This is called bradycardia, and it can leave you feeling tired, dizzy, or lightheaded.
The good news is that this is a well-known combination that your care team can manage. They may check your heart rate and keep an eye on how you feel. Keep taking both exactly as prescribed, and let your pharmacist or doctor know if you feel unusually slow, faint, or dizzy.
Interaction: Additive negative chronotropic and dromotropic effects. Both atenolol (beta-1 blockade) and deslanoside (cardiac glycoside) slow SA node firing and AV nodal conduction, increasing the risk of bradycardia and potentially unmasking digitalis toxicity.
- Direction: Additive pharmacodynamic effect (not a metabolic/prodrug interaction).
- Severity/Evidence: Moderate; probable substantiation. Onset unspecified.
- Monitoring: Heart rate and PR interval; assess for symptomatic bradycardia and glycoside toxicity.
- Management: If severe bradycardia develops, the beta-blocker dose may be reduced or discontinued. Doses should be individualized by the care team.
What happens
Increased risk of bradycardia and possible digitalis glycoside toxicity
Interaction Deep Dive
Because digitalis glycosides and beta-blockers both prolong atrioventricular conduction and lower heart rate, using them together may heighten the likelihood of bradycardia3412. When these agents are given concurrently, heart rate and PR interval should be tracked34. Should severe bradycardia occur, metoprolol should be lowered or stopped1.
Why it happens (mechanism)
Additive effects on AV node conduction
How to manage this interaction
This combination is used intentionally at times, but because both drugs slow the heart, your team will manage it carefully.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your team may monitor your heart rate and PR interval (an ECG measurement) and watch for symptoms.
- If your heart rate drops too low, the atenolol dose may be adjusted or lowered by your care team; doses are individualized.
- Call your pharmacist or doctor if you feel dizzy, faint, very tired, or notice a slow or irregular pulse.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In children, carvedilol raised serum digoxin levels, and the dose may require reduction to prevent toxicity. Eight children treated with digoxin for ventricular failure resulting from complex congenital heart disease were monitored for any pharmacokinetic interactions both before and after carvedilol was added. These children were between 2 weeks and 7.8 years of age, and the daily carvedilol dose was adjusted based on clinical response. Digoxin clearance was determined before and after carvedilol had been maintained at an unchanged dose for at least 4 days. In one child, carvedilol was discontinued on 2 occasions, which produced a fall in the apparent clearance of digoxin and then a rebound in clearance once the drug was stopped. The carvedilol dose ranged from 0.1 mg/kg/day to 1.02 mg/kg/day. GFR showed no significant change before and after carvedilol was given. Digoxin clearance decreased on average by 2-fold (from 153.0 +/- 92.3 mL/min/1.73 m(2) to 80.6 +/- 23.9 mL/min/1.73 m(2), p=0.056), and the ratio of digoxin clearance to GFR fell from 1.8 +/- 0.60 to 1.00 +/- 0.24 (p=0.002). Multiple regression analysis incorporating age, initial ratio, and carvedilol dose supported the univariate analysis, with the initial ratio being the significant factor (p=0.05), while dose (p=0.78) and age (p=0.5) were not significant. The author concluded that the carvedilol and digoxin interaction is heightened in children, possibly due to greater expression of the P-glycoprotein pump 5.
Common questions
Can I take Deslanoside and Atenolol together?
Taking atenolol and deslanoside together can add up to slow your heart too much, so your care team will monitor your heart rate and may adjust the atenolol dose. Keep taking both as prescribed and report dizziness, fainting, or a very slow pulse. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Deslanoside and Atenolol interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Deslanoside and Atenolol interaction managed?
This combination is used intentionally at times, but because both drugs slow the heart, your team will manage it carefully. Keep taking both as prescribed unless your prescriber tells you otherwise. Your team may monitor your heart rate and PR interval (an ECG measurement) and watch for symptoms. If your heart rate drops too low, the atenolol dose may be adjusted or lowered by your care team; dose… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Deslanoside or Atenolol 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 anything you'd monitor while I'm on both?
References (5)
- Product Information: TOPROL-XL(R) oral extended-release tablets, metoprolol succinate oral extended-release tablets. Aralez Pharmaceuticals US Inc (per FDA), Parsippany, NJ, 2022. DailyMed
- Product Information: KAPSPARGO SPRINKLE(R) oral extended-release capsules, metoprolol succinate oral extended-release capsules. Sun Pharmaceutical Industries Inc (per DailyMed), Cranbury, NJ, 2020. DailyMed
- Product Information: Lopressor(R) oral tablets, metoprolol tartrate oral tablets. Validus Pharmaceuticals, LLC (per FDA), Parsippany, NJ, 2013. DailyMed
- Product Information: Lopressor(R) intravenous injection, metoprolol tartrate intravenous injection. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2013. DailyMed
- Ratnapalan S, Griffiths K, Moldovan Costei A, et al: Digoxin-carvedilol interactions in children. J Pediatr 2003; 142:572-574. PubMed
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