Beta blockers and intravenous roentgen contrast materials: Which risks do exist?

Published:August 13, 2016DOI:
      Currently, beta blockers (e.g. metoprolol, atenolol, bisoprolol, esmolol, nebivolol, propranolol, pindolol) are broadly used to treat diseases like hypertension, tachycardia, cardiac arrhythmia, congestive heart failure, essential tremor, migraine prophylaxis, and myocardial infarction for example. Both beta blockers and iodinated radio-contrast media (ICM) are frequently used, so that a relevant proportion of patients undergoing ICM-enhanced computed tomography (CT) or other X-ray-related imaging procedures can be estimated to be under treatment with beta blockers. Usually, ICM are well tolerated and safe. However, adverse events (AEs) and hypersensitivity reactions (HSRs) still occur in a small percentage of patients. Especially, patients at risk will acquire AEs/HSRs. Therefore, the identification of risks is mandatory to efficiently avoid ICM side effects. While a history of a previous ICM reaction/allergy is a well-known risk and a clear indication for a prophylactic task, other risks such as intake of beta-blockers are less clear and, therefore, still a matter of debate. Since GPs should be involved in the decision process to safely manage the application of ICM, we summarized the current knowledge concerning beta-blocker medication while undergoing ICM-enhanced radiological imaging procedure.


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