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Bucindolol

Beta Blocker · Antihypertensive

Beta BlockerAntihypertensive
CDSCO approvedSchedule H
EXCRETION
not curated
INTERACTIONS
9 major
incl. contraindicated
PREGNANCY
not curated
Top interactionssee all 12
  • DiltiazemContraindicatedTextbookG&G 14e · p617
  • RitodrineContraindicatedTextbookKDT 7e · p333
  • AdrenalineSevereTextbookKDT 7e · p133
  • AmilorideSevereTextbookKDT 7e

Mechanism

Bucindolol is a nonselective beta-adrenergic receptor antagonist with additional capacity to block alpha-1 adrenergic receptors. Beta-receptor blockade reduces sympathetic activity on the heart. Alpha-1 receptor blockade inhibits vasoconstriction induced by endogenous catecholamines, leading to vasodilation, decreased peripheral resistance, and a subsequent fall in blood pressure.

Dosing

Adult
commonly used for this purpose. Atenolol and timolol are also effective. Atenolol has the disadvantage that it is cleared by the kidney and its dose has to be adjusted in patients with renal failure. FIGURE 10–8 Effects of β­blocker therapy on life­table cumulated rates of mortality from all causes over 6 years among 1884 patients surviving myocardial infarctions.…

Side effects

Serious
  • life-threatening bradyarrhythmias (with AV conduction defects or other drugs)
  • exacerbation of angina (abrupt discontinuation)
  • increased risk of sudden death (abrupt discontinuation)
  • blunted recognition/delayed recovery from hypoglycemia

Drug interactions

Diltiazem
Contraindicated
Textbook

Increased propensity for AV block, severe bradycardia, and decreased left ventricular function.

Avoid concurrent administration. The concurrent administration of diltiazem with a beta blocker is contraindicated.

Source: G&G 14e · p617

Ritodrine
Contraindicated
Textbook

Reduced efficacy of ritodrine and potential for adverse cardiovascular effects.

Ritodrine should not be used if the mother is receiving beta blockers.

Source: KDT 7e · p333

Adrenaline
Severe
Textbook

Marked rise in BP.

Adrenaline should not be given to patients receiving β blockers.

Source: KDT 7e · p133

Amiloride
Severe
Textbook

Hyperkalaemia more likely.

Source: KDT 7e

Epinephrine
Severe
Textbook

Severe hypertension and cerebral hemorrhage.

The use of epinephrine generally is contraindicated in patients who are receiving nonselective β receptor antagonists.

Source: G&G 14e · p258

Methacholine
Severe
Textbook

Exaggerated or prolonged bronchoconstriction and reduction in vital capacity in response to methacholine.

Emergency resuscitation equipment, oxygen, and medications to treat severe bronchospasm (e.g., β2 adrenergic receptor agonists for inhalation) should be available during testing.

Source: G&G 14e · p212

Sofosbuvir
Severe
Textbook

Severe bradycardia.

Extreme caution advised if amiodarone is co-administered with sofosbuvir and a beta blocker.

Source: Harrison 22e · unknown

Triamterene
Severe
Textbook

Hyperkalaemia more likely.

Source: KDT 7e

Verapamil
Severe
Textbook

Life-threatening bradyarrhythmias.

Particular caution is indicated.

Source: G&G 14e · p275

Aceclofenac + Paracetamol
Moderate
Textbook

Reduced antihypertensive effect.

Monitor blood pressure and consider alternative antihypertensive agents or NSAIDs if necessary.

Source: G&G 14e · p275

Aceclofenac
Moderate
Textbook

Reduced antihypertensive effect.

Monitor blood pressure and consider alternative antihypertensive agents or NSAIDs if necessary.

Source: G&G 14e · p275

Alfuzosin
Moderate
Textbook

Increased antihypertensive effect.

This combination is often used to achieve better blood pressure control and manage reflex tachycardia from alpha-1 blockers.

Source: G&G 14e

Related guidelines

Other Beta Blocker drugs

Ask House about Bucindolol

Continue into a citation-backed clinical answer with the drug context already attached.

Sources: Goodman & Gilman 14e, Katzung·Verified: 2026-05-13 · House clinical team