Ranitidine Nebivolol

Kamali F, Howes A Thomas SHL, Ford GA Snoeck E. A pharmacokinetic and pharmaco-(fynamic interaction stuefy between nebivolol and the H2-receptor antagonists cimetidine and ranitidine. BrJ Clin Pharmacol (1997) 43,201-4. 

Ranitidine does not alter either the steady-state plasma levels or the therapeutic effects of atenolol, nebivolol, propranolol or terta-tolol. Some studies have shown moderate rises in metoprolol levels in those also given ranitidine, but this is not clinically important. 

Similarly, in other studies, ranitidine 150 mg twice daily did not significantly alter the pharmacokinetic or pharmacodynamic effects of a single 5-mg dose of nebivolol, a single 5-mg dose of tertatolol, or atenolol 100 mg daily for 7 days. - ... 

The possible effects of ranitidine on the plasma levels and effects of propranolol and metoprolol have been well studied. Although some studies have shown moderate rises in metoprolol levels, particularly after singledoses, these increases are of a magnitude that is unlikely to be clinically important. Less is known about atenolol, nebivolol and tertatolol, although no clinically relevant interactions have been seen. There is nothing to suggest that the concurrent use of ranitidine and any beta blocker should be avoided, nor that there is any need to take particular precautions. 

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