Landiolol 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
Landiolol
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 and landiolol are both beta-blockers, which means they each slow your heart rate and ease how hard your heart squeezes. When you take them together, those effects can stack up. That could make your heart beat too slowly (bradycardia), lower how forcefully it pumps, or slow the electrical signals in your heart (heart block).
This concern is theoretical, based on how these medicines work rather than lots of real-world reports, but because it involves your heart it is taken seriously. The good news is your care team can manage this by watching you closely and tailoring your treatment. Never stop or change either drug on your own, just talk with your pharmacist or doctor.
Mechanism: additive negative inotropic and chronotropic effects. Atenolol (cardioselective beta-1 antagonist) and landiolol (ultra-short-acting IV beta-1 antagonist) both depress myocardial contractility, sinoatrial rate, and AV conduction. Combined use is additive, not PK-mediated; neither is a prodrug.
Direction: increased risk of bradycardia, AV block, and reduced contractility.
- Evidence: theoretical (pharmacodynamic).
- Onset: unspecified.
- Management: manufacturer advises avoiding concomitant use. If unavoidable, continuous cardiac and hemodynamic monitoring (heart rate, ECG for conduction, blood pressure) with dose individualized by the team.
What happens
An increased risk of myocardial contractility depression and increase the risk of bradycardia or heart block
Interaction Deep Dive
Landiolol should not be given together with negative inotropic or chronotropic agents, or with drugs that reduce heart rate or slow cardiac conduction, such as beta-blockers. When landiolol is combined with negative inotropes or chronotropes, the potential for suppression of myocardial contractility may be heightened, along with a greater likelihood of bradycardia or heart block1.
Why it happens (mechanism)
Additive cardiovascular effects
How to manage this interaction
Landiolol is a short-acting IV beta-blocker usually given in a monitored hospital setting, so your care team will already know what other heart medicines you take, including atenolol.
- Because both drugs slow the heart, the guidance is to avoid using them together when possible; your team may choose an alternative or adjust your treatment.
- If both are needed, expect closer monitoring of your heart rate, rhythm, and blood pressure, with dosing individualized by your team.
- Keep taking your prescribed medicines and tell your pharmacist or doctor about all of them, and report dizziness, fainting, or a very slow pulse.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Landiolol and Atenolol together?
Combining atenolol with landiolol can stack their heart-slowing effects and raise the risk of a dangerously slow heartbeat or heart block, so this combo is generally avoided. If both are needed, your care team will monitor your heart closely and adjust treatment. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Landiolol and Atenolol 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 is the Landiolol and Atenolol interaction managed?
Landiolol is a short-acting IV beta-blocker usually given in a monitored hospital setting, so your care team will already know what other heart medicines you take, including atenolol. Because both drugs slow the heart, the guidance is to avoid using them together when possible; your team may choose an alternative or adjust your treatment. If both are needed, expect closer monitoring of your heart… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Landiolol 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 a safer alternative to one of these medications for me?
References (1)
- Product Information: RAPIBLYK intravenous injection lyophilized powder for solution, landiolol intravenous injection lyophilized powder for solution. AOP Orphan Pharmaceuticals GmbH (per FDA), 2024. DailyMed
Keep reading about Atenolol
Keep reading about Landiolol
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