carvedilol × Theophylline

Carvedilol blocks β2-adrenergic receptors (non-selective beta-blocker) and causes bronchoconstriction in asthma or COPD. Theophylline becomes less effective in these conditions.

Recurrence of asthma or COPD symptoms: dyspnoea, wheezing, need for additional short-acting β2-agonist doses. In severe asthma: risk of severe bronchospasm.

Avoid the combination in asthma and severe COPD. In heart failure with mild COPD, a selective beta-blocker (bisoprolol, metoprolol) is preferred. Alternative to theophylline: long-acting inhaled β2-agonists with anticholinergics.