Lidoflazine and Esmolol: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Esmolol
Lidoflazine
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
Hypotension, bradycardia, and AV conduction disturbances
Interaction Deep Dive
The combination of lidoflazine with beta blocking drugs, while likely to be uneventful, may cause hypotension, bradycardia, or impair cardiac performance due to additive effects that reduce cardiac contractility and AV node conduction. There are no cases that document such adverse experiences with this combination, but based on experience with other calcium channel blockers, these effects would be most likely to occur in patients with impaired left ventricular function, impaired cardiac conduction, or aortic stenosis345. Lidoflazine has other antiarrhythmic cardiac effects and may thus potentially have an increased risk of proarrhythmia when used with beta blockers which possess significant membrane stabilizing activity (particularly sotalol and propranolol) 6.
Why it happens (mechanism)
Additive cardiovascular effects
Literature reports
1 report — tap to read
a) In angina patients stabilized with propranolol, lidoflazine was added gradually up to 360 mg daily. Four of these patients developed ventricular tachycardia. All symptoms subsided after lidoflazine was discontinued 1. Conversely, another study combining lidoflazine, titrated to 360 mg daily, with propranolol 80 mg to 400 mg daily did not reveal evidence of increased arrhythmogenesis. Compared with propranolol alone, the combination significantly prolonged the QT interval, but ventricular tachycardia did not result. Also, the lidoflazine-propranolol combination did not provide significant improvement with exercise tolerance compared with propranolol alone 2.
Common questions
Can I take Lidoflazine and Esmolol together?
Hypotension, bradycardia, and AV conduction disturbances Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lidoflazine and Esmolol interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
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 Lidoflazine or Esmolol 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 (6)
- Hanley SP & Hampton JR: Ventricular arrhythmias associated with lidoflazine: side-effects observed in a randomized trial. Eur Heart J 1983; 4(12):889-893. PubMed
- Charlap S, Kimmel B, Berezow J, et al: Lidoflazine and propranolol combination treatment in chronic stable angina. Angiology 1985; 36:240-252. DOI
- Robson RH & Vishwanath MC: Nifedipine and beta-blockade as a cause of cardiac failure. Br Med J 1982; 284:104. PubMed
- Anastassiades C: Nifedipine and beta-blockade as a cause of cardiac failure (letter). Br Med J Clin Res Ed 1982; 284:506. PubMed
- Maclean D, Mitchell ET, Coulson RR, et al: Atenolol-nifedipine combinations compared to atenolol alone in hypertension: efficacy and tolerability. Br J Clin Pharmacol 1988; 25:425-431. DOI
- Hanley SP & Hampton JR: Ventricular arrhythmias associated with lidoflazine: side effects observed in a randomized trial. Eur Heart J 1983; 4:889-893. PubMed
Keep reading about Esmolol
Keep reading about Lidoflazine
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist