Pindolol

Concurrent use with beta-blockers is not recommended. Possibly significant hypertension may theoretically occur up to 14 days following discontinuation of the MAO inhibitor.

Concomitant use of beta-blockers with tricyclic antidepressants, barbiturates and phenothiazines as well as other antihypertensive agents may increase the blood pressure lowering effect.

Concomitant use of beta-blockers may intensify the blood sugar lowering effect of insulin and other antidiabetic drugs since hypoglycaemia may occur during prolonged fasting. Use of beta-blockers may prevent appearance of the signs of hypocalcaemia (tachycardia).

Use of digitalis glycosides, in association with beta-adrenoceptor blocking drugs, may increase atrio-ventricular conduction time.

Caution should be exercised in the concurrent use of beta-blocking agents with class 1 antiarrhythmics (e.g. disopyramide, quinidine) and amiodarone.

Prostaglandin synthetase inhibiting drugs (e.g. Non-steroidal anti-inflammatory drugs – NSAIDs) may decrease the hypotensive effects of beta-blockers.

Cimetidine, hydralazine and alcohol may induce increased plasma levels of hepatically metabolised beta-blockers.

When therapy is discontinued in patients receiving a beta-blocker and clonidine concurrently, the beta-blockers should be gradually discontinued several days before clonidine is discontinued, in order to reduce the potential risk of a clonidine withdrawal hypertensive crisis.

During treatment with pindolol patients should not undergo anaesthesia with agents causing myocardial depression (e.g. halothane, cyclopropane, trichlorethylene, ether, chloroform). Pindolol should be gradually withdrawn before elective surgery. In emergency surgery or cases where withdrawal of pindolol would cause deterioration in cardiac condition, atropine sulphate 1 to 2 mg intravenously should be given to prevent severe bradycardia.

Concurrent use may result in an additive and possibly excessive beta-adrenergic blockade.

Patients with psoriasis should take beta-blockers only after careful consideration.

Pindolol is contraindicated in pregnancy.

Pindolol passes in small quantities into breast milk Breast-feeding is therefore not recommended following administration.

Because dizziness or fatigue may occur during the initial phase of treatment with beta-adrenoceptor blocking drugs, patients driving vehicles or operating machinery should exercise caution until their individual response to treatment has been determined.