Levodopa Beta blockers

LEVODOPA BETA-BLOCKERS t hypotensive effect Additive hypotensive effect however, overall, adding beta-blockers to levodopa can be beneficial (e.g. by reducing the risk of a dopamine-mediated risk of arrhythmias) Monitor BP at least weekly until stable... 

Drugs that may affect methyidopa include levodopa, nonselective beta-blockers (eg, propranolol), and ferrous sulfate or gluconate. 

Drugs that may increase the effects or side effects of bupropion include levodopa, MAOIs, ritonavir, antidepressants, antipsychotics, beta blockers, type 1C antiarrhythmics. 

The concurrent use of levodopa and beta blockers normally appears to be favourable, but be aware that, as with all antihypertensives, additive hypotensive effects can occur. 

Most of the effects of the combined use of levodopa and beta blockers seem to be favourable, although additive hypotension can be a problem. Dopamine derived from levodopa stimulates beta-receptors in the heart, which can cause arrhythmias. These receptors are blocked by propranolol and other beta blockers. An enhancement of the effects of levodopa and a reduction in tremor has been described in 23 out of 25 patients taking propranolol, but not in 9 patients taking oxprenolol, or in another placebo-controlled study in 18 patients taking propranolol. Early evidence showed that growth hormone levels were substantially raised by propranolol or practolol [now withdrawn due to fatal reactions] in conjunction with levodopa, but no clinical relevance for this has been demonstrated. 

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