Metoprolol drug interactions

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884

Metoprolol drug interactions

General Aspects

Risk of Anaphylactic Reaction

General Anesthetics

CYP2D6 Inhibitors

Clonidine

Major Drug Interactions of Metoprolol

Moderate Drug Interactions of Metoprolol

Minor Drug Interactions of Metoprolol

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General Aspects

Catecholamine-depleting drugs (e.g., reserpine) may have an additive effect when given with beta-blocking agents. Patients treated with Metoprolol plus a catecholamine depletor should therefore be closely observed for evidence of hypotension or marked bradycardia, which may produce vertigo, syncope, or postural hypotension.

Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.

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Risk of Anaphylactic Reaction

While taking beta-blockers, patients with a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated challenge, either accidental, diagnostic, or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction.

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General Anesthetics

Some inhalation anesthetics may enhance the cardiodepressant effect of beta-blockers.

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CYP2D6 Inhibitors

Potent inhibitors of the CYP2D6 enzyme may increase the plasma concentration of Metoprolol. Strong inhibition of CYP2D6 would mimic the pharmacokinetics of CYP2D6 poor metabolizer. Caution should therefore be exercised when co-administering potent CYP2D6 inhibitors with Metoprolol. Known clinically significant potent inhibitors of CYP2D6 are antidepressants such as fluoxetine, paroxetine or bupropion, antipsychotics such as thioridazine, antiarrhythmics such as quinidine or propafenone, antiretrovirals such as ritonavir, antihistamines such as diphenhydramine, antimalarials such as hydroxychloroquine or quinidine, antifungals such as terbinafine and medications for stomach ulcers such as cimetidine.

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Clonidine

If a patient is treated with clonidine and Metoprolol concurrently, and clonidine treatment is to be discontinued, Metoprolol should be stopped several days before clonidine is withdrawn. Rebound hypertension that can follow withdrawal of clonidine may be increased in patients receiving concurrent beta-blocker treatment.

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Major Drug Interactions of Metoprolol

In alphabetical order

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Moderate Drug Interactions of Metoprolol

Contents: Top - 0–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

0-9

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A

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B

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C

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D

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E

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F

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G

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H

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I

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K

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L

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M