may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.tolterodinetiotropium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.toremifenetoremifene and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiastorsemidetorsemide and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.tranylcyprominetranylcypromine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. MAO inhibitors prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiastrazodonetiotropium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.triamcinolone acetonide injectable suspensiontriamcinolone acetonide injectable suspension and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.trifluoperazinetiotropium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.tiotropium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.trifluoperazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.trifluoperazine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiastrihexyphenidyltiotropium and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimipraminetrimipramine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiastrimipraminetiotropium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.trospium chloridetiotropium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.umeclidinium bromideumeclidinium bromide and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agentsumeclidinium bromide/vilanterol inhaledumeclidinium bromide/vilanterol inhaled and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effectsvalbenazinevalbenazine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.vandetanibvandetanib and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasvardenafilvardenafil and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasvecuroniumtiotropium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.vilanterol/fluticasone furoate inhaledvilanterol/fluticasone furoate inhaled and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effectsvoriconazolevoriconazole and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasvorinostatvorinostat and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasziprasidoneziprasidone and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiastiotropium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ziprasidone increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tiotropium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.zotepinetiotropium decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.tiotropium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.Minor (3)dimenhydrinatedimenhydrinate increases toxicity of tiotropium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.donepezildonepezil decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.galantaminegalantamine decreases effects of tiotropium by pharmacodynamic antagonism. Minor/Significance Unknown.abirateroneMonitor Closely (1)abiraterone and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasabobotulinumtoxinAMonitor Closely (1)abobotulinumtoxinA increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .acebutololMonitor Closely (1)acebutolol, olodaterol inhaled. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Beta-blockers and olodaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.albuterolMonitor Closely (2)albuterol and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. albuterol and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effectsalfuzosinMonitor Closely (1)alfuzosin and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasamantadineMonitor Closely (1)tiotropium, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.amiodaroneMonitor Closely (1)amiodarone and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasamisulprideSerious - Use Alternative (1)amisulpride and olodaterol inhaled both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylineMonitor Closely (2)amitriptyline and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias tiotropium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.amoxapineMonitor Closely (2)amoxapine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias tiotropium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.anticholinergic/sedative combosMonitor Closely (1)anticholinergic/sedative combos and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.apomorphineMonitor Closely (1)apomorphine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasarformoterolMonitor Closely (2)arformoterol and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects arformoterol and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.aripiprazoleMonitor Closely (4)aripiprazole and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. tiotropium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. tiotropium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. aripiprazole increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.arsenic trioxideMonitor Closely (1)arsenic trioxide and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasartemetherMonitor Closely (1)artemether and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.artemether/lumefantrineMonitor Closely (1)artemether/lumefantrine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasasenapineMonitor Closely (1)asenapine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasasenapine transdermalMonitor Closely (1)asenapine transdermal and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasatomoxetineMonitor Closely (1)atomoxetine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.atracuriumMonitor Closely (1)atracurium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineMonitor Closely (1)atropine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.atropine IV/IMMonitor Closely (1)atropine IV/IM and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.azithromycinMonitor Closely (1)azithromycin and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasbelladonna alkaloidsMonitor Closely (1)belladonna alkaloids and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumMonitor Closely (1)belladonna and opium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.bendroflumethiazideMonitor Closely (1)bendroflumethiazide and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.benperidolMonitor Closely (3)tiotropium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor. benperidol increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.benztropineMonitor Closely (1)benztropine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. betamethasoneMonitor Closely (1)betamethasone and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.bethanecholMonitor Closely (1)bethanechol increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.bosutinibMonitor Closely (1)bosutinib and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.bumetanideMonitor Closely (1)bumetanide and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.capecitabineMonitor Closely (1)capecitabine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.carbacholMonitor Closely (1)carbachol increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carvedilolMonitor Closely (1)carvedilol, olodaterol inhaled. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor. Beta-blockers and olodaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.ceritinibMonitor Closely (1)ceritinib and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.cevimelineMonitor Closely (1)cevimeline increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloroquineSerious - Use Alternative (1)chloroquine and olodaterol inhaled both increase QTc interval. Avoid or Use Alternate Drug.chlorothiazideMonitor Closely (1)chlorothiazide and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.chlorpromazineMonitor Closely (4)chlorpromazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. tiotropium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor. chlorpromazine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias tiotropium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.chlorthalidoneMonitor Closely (1)chlorthalidone and olodaterol inhaled both decrease serum potassium. Use Caution/Monitor.ciprofloxacinMonitor Closely (1)ciprofloxacin and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiascisatracuriumMonitor Closely (1)cisatracurium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.citalopramMonitor Closely (1)citalopram and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasclarithromycinMonitor Closely (1)clarithromycin and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasclomipramineMonitor Closely (2)clomipramine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias tiotropium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.clozapineMonitor Closely (4)tiotropium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor. clozapine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. tiotropium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. clozapine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.corticotropinMonitor Closely (1)corticotropin