Propranolol and Albuterol Interaction Guidelines

Introduction to Contraindications

• The European Society of Cardiology guidelines identify a history of asthma as a contraindication to the use of any beta-blocker 1
• The American College of Chest Physicians acknowledges that COPD is a frequent comorbidity in patients requiring cardiac medications, creating a common clinical dilemma 1

Clinical Management Recommendations

• The European Society of Cardiology states that the majority of patients with heart failure and COPD can safely tolerate beta-blocker therapy when cardioselective agents are used 1
• The European Society of Cardiology recommends initiating cardioselective beta-blockers at the lowest possible dose with gradual up-titration while monitoring pulmonary function 1
• The American College of Chest Physicians suggests ensuring inhaled β2-agonists, such as albuterol, are administered as required for breakthrough symptoms, even with cardioselective beta-blockers 1