Moderate
Bisoprolol × Diazepam
Selective beta-adrenergic blockers×Anxiolytics. Benzodiazepine derivatives
Mechanism
Additive CNS depression and mild hypotension. Diazepam sedation may mask early symptoms of excessive blood pressure drop.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk. With additional antihypertensives: bradycardia (pulse below 60/min).
Management
The combination is acceptable for short diazepam use with pulse and blood pressure monitoring. In older patients: lorazepam or oxazepam at minimum doses (short-acting, less accumulation risk).