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Is It Safe To Take Bystolic With Prozac?

Posted on Sat, 4 Jan 2014

Question: Hello i am not bystolic 5mg since october 3rd, i am taking also prisitq 50, but it seems that since it worksmon norpinephrine is counteracting the bystolic effect. So my doctor wanted me to switch to prozac 20 mg. i know that bystolic has some interaction with prozac. Do you think will it be safe to use both? Thanks.

Answered by Dr. Benard Shehu (48 hours later)

Brief Answer: Please refer to the following answer. Detailed Answer: Hi, Yes, it is true that prozac has some interaction with bystolic by enhancing its effects (bystolic effect), leading to bradycardia and hypotension. So the combination should be used under medical surveillance (monitor BP and heart rate) to be safe, otherwise shouldn't be used together. If I was your caring doctors, would start with a dose of 10 mg of prozac, and closely monitor your blood pressure and heart heart. Than gradually, I'd suggest to increase the dose to 20 mg. At the end, I strongly suggest to follow your doctor's advise and to keep monitoring your blood pressure and heart rate. You can discuss with your doctor for other combination therapy safer than bystolic and prozac. Feel free to ask me other questions you might have! Dr.Benard

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Benard Shehu (26 minutes later)

Hello, Thanks for reply. My doctor today switched me from pristiq 50 mg to zoloft 50 mg, but he said there is no problem taking bystolic 5 mg. I hope so. Anyway I have blood pressure monitor and also heart rate monitor. I will watch it carefully. Maybe with sertraline there is less interaction. Tomorrow morning i am suppose to take the new regimen. I am unsure if maybe I could reduce bystolic to half pill tomorrow and see how it goes. What do you think?

Answered by Dr. Benard Shehu (5 hours later)

Brief Answer: Please refer to the answer below. Detailed Answer: Hi again, Thank you for sending in more of your medical data. There is still the same interaction between zoloft and bystolic (also zoloft increase the effect of bystolic). So, I'd strongly suggest to closely monitor your blood pressure and heart rate. If I was your caring doctor would start a lower dose of zoloft first without changing the dose of bystolic. Then, can increase zoloft dose gradually until the desired dosing. Hope it answered to your query! Dr.Benard If you are satisfied with my answer, please close this thread and kindly rate my answer!

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Benard Shehu (30 hours later)

Hello, My doctor prescribed me 50 mg of Zoloft and 5 mg of Bystolic he said that is fine. I checked and yes, there is interaction but it seems to be Zoloft moderate inhibitor of 2D6 cytochrome if i remember correctly, less than fluoxetine. Can you please check? Anyway yesterday i took them and it was ok, no spikes in blood pressure or heart rate.

Answered by Dr. Benard Shehu (11 hours later)

Brief Answer: Please refer to the following answer. Detailed Answer: Hi again, Thank you for sending in your feedback. I am glad to hear that the therapy you just started did not give any negative impact. It is also true that Zoloft does inhibate the 2D6 cytochrome less than fluoxetine. However, I keep on advising to monitor blood pressure (for low blood pressure) and heart rates (for low heart beats - bradycardia). Hope the therapy will have positive effects and improvement! Dr.Benard

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Above answer was peer-reviewed by : Dr. Vaishalee Punj