Metoprolol interactions
Metoprolol (Lopressor, Toprol-XL, Kapspargo), a beta blocker has 200 documented interactions across the FDA labels and fact sheets we index: 27 major, 125 moderate, 46 minor, and 2 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (27)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
• Concomitant administration with IV beta-blockers. (Diltiazem label, Contraindications)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
Concomitant negative chronotropic therapy such as digoxin or beta-blockers may lower the risk of this complication. (Flecainide label, Boxed warning)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)
Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
Hypotensive Agents Do not use BYSTOLIC with other β-blockers. (Nebivolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
Examples: beta-blockers, clonidine, guanethidine, and reserpine Clopidogrel : Avoid concomitant use; if used concomitantly initiate at 0.5 mg before each meal and limit total daily dose to 4 mg ( 7 ) (Repaglinide label, Drug interactions)
Concomitant use with metoclopramide, beta-blockers, or cholinomimetic and anticholinergic drugs is not recommended ( 7.1 , 7.2 , 7.3 ) (Rivastigmine label, Drug interactions)
…coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)
CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (Metoprolol label, Drug interactions)
…Syndrome (SS) c ] Agents with blood pressure-reducing effects Use with caution d Hypotension e Non-selective H1 receptor antagonists Contraindicated a Increased anticholinergic effects Beta-adrenergic blockers (see also agents or procedures with blood pressure-reducing effects) Use with the caution d More pronounced bradycardia, postural hypotension e Blood glucose-lowering… (Tranylcypromine label, Drug interactions)
Moderate interactions (125)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)
- ArmodafinilCNS stimulantModerate
There was also a slightly greater proportion of patients on NUVIGIL requiring new or increased use of antihypertensive medications (2.9%) compared to patients on placebo (1.8%). (Armodafinil label, Warnings and precautions)
- AsenapineantipsychoticModerate
Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)
- Aspirin and dipyridamoleantiplatelet agentModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
Because of its relative beta 1 selectivity, however, TENORMIN may be used with caution in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Atenolol label, Warnings)
Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)
- AvanafilPDE5 inhibitorModerate
• Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 ) (Avanafil label, Warnings and precautions)
Because of its relative beta 1 -selectivity, however, BISOPROLOL FUMARATE may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol label, Warnings)
- Bisoprolol and hydrochlorothiazidebeta blockerModerate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- BrexpiprazoleantipsychoticModerate
Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)
Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)
- Budesonide and formoterolcorticosteroidModerate
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)
- CariprazineantipsychoticModerate
Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)
COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)
Intervention: • During concomitant use of VYSCOXA and ACE inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Celecoxib label, Drug interactions)
- Cevimelinecholinergic agonistModerate
DRUG INTERACTIONS Cevimeline should be administered with caution to patients taking beta adrenergic antagonists, because of the possibility of conduction disturbances. (Cevimeline label, Drug interactions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Concomitant use of glycosides, clonidine, and diltiazem and verapamil with beta-blockers can increase the risk of bradycardia. (Metoprolol label, Drug interactions)
…concomitant use of TONMYA with: MAO inhibitors may be life-threatening [see Contraindications (4) ] , Alcohol, barbiturates, and other CNS depressants may increase the risk of adverse reactions associated with these drugs, Tramadol may increase the seizure risk, Guanethidine or other similar acting drugs may block the antihypertensive action of these drugs. (Cyclobenzaprine label, Drug interactions)
- CyclosporineimmunosuppressantModerate
If hypertension persists, the dose of Neoral should be further reduced or blood pressure should be controlled with antihypertensive agents. (Cyclosporine label, Precautions)
- DeutetrabenazineVMAT2 inhibitorModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
• Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)
Intervention: During concomitant use of Diclofenac Potassium and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Diclofenac label, Drug interactions)
Digitalis glycosides, clonidine, diltiazem, and verapamil slow atrioventricular conduction and decrease heart rate. (Metoprolol label, Drug interactions)
- Dihydroergotamineergot alkaloidModerate
Beta Blockers Although the results of a clinical study did not indicate a safety problem associated with the administration of Dihydroergotamine Mesylate Injection, USP to subjects already receiving propranolol, there have been reports that propranolol may potentiate the vasoconstrictive action of ergotamine by blocking the vasodilating property of epinephrine. (Dihydroergotamine label, Drug interactions)
- DofetilideantiarrhythmicModerate
Concomitant medications were grouped as ACE inhibitors, oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular… (Dofetilide label, Drug interactions)
- DronedaroneantiarrhythmicModerate
Give a low dose of beta-blockers initially, and increase only after ECG verification of good tolerability [see Drug Interactions (7.3) , Clinical Pharmacology (12.3) ] . (Dronedarone label, Drug interactions)
- EpinephrinesympathomimeticModerate
Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction. (Metoprolol label, Warnings and precautions)
- Eplerenonealdosterone antagonistModerate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- Epoetin alfaModerate
Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa label, Warnings and precautions)
- Esmololbeta blockerModerate
• Antihypertensive agents clonidine, guanfacine, or moxonidine: Beta blockers also increase the risk of clonidine-, guanfacine-, or moxonidine-withdrawal rebound hypertension. (Esmolol label, Drug interactions)
- Ethacrynic acidloop diureticModerate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- Felodipinedihydropyridine calcium channel blockerModerate
The AUC and C max of metoprolol, however, were increased approximately 31 and 38%, respectively. (Felodipine label, Drug interactions)
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- FluvoxamineSSRIModerate
Propranolol or metoprolol : Reduce dose if coadministered and titrate more cautiously ( 7.3 ). (Fluvoxamine label, Drug interactions)
- Formoterolbeta-adrenergic agonistModerate
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
The signs of hypoglycemia may be reduced or absent in patients taking sympatholytic drugs such as beta-blockers, clonidine, guanethidine, and reserpine. (Glimepiride label, Drug interactions)
The signs of hypoglycemia may be reduced or absent in patients taking sympatholytic drugs such as beta-blockers, clonidine, guanethidine, and reserpine. (Glipizide label, Drug interactions)
- GlucagonModerate
Table 4: Clinically Significant Drug Interaction with GVOKE and GVOKE VialDx Beta-Blockers Clincial Impact: Patients taking beta-blockers may have a transient increase in pulse and blood pressure when given GVOKE or GVOKE VialDx. (Glucagon label, Drug interactions)
…Interactions The hypoglycemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents, ACE inhibitors, disopyramide, fluoxetine, clarithromycin, and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, monoamine oxidase inhibitors, and beta adrenergic blocking agents. (Glyburide label, Drug interactions)
Orthostatic vital signs should be monitored in patients who are at risk for hypotension (e.g., geriatric patients, patients with dehydration, hypovolemia, and concomitantly treated with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Haloperidol label, Warnings and precautions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Intervention: During concomitant use of CALDOLOR and ACE-inhibitors, ARBs, or beta- blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Ibuprofen label, Drug interactions)
- IloperidoneantipsychoticModerate
Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Iloperidone label, Warnings and precautions)
- Indapamidethiazide diureticModerate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Intervention: During concomitant use of INDOCIN and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Indomethacin label, Drug interactions)
Symptomatic awareness of hypoglycemia may be less pronounced in patients with longstanding diabetes in patients with diabetic nerve disease, in patients using medications that block the sympathetic nervous system (e.g., beta-blockers) [see Drug Interactions ( 7 )] , or in patients who experience recurrent hypoglycemia. (Insulin aspart label, Warnings and precautions)
- Insulin degludecinsulinModerate
Symptomatic awareness of hypoglycemia may be less pronounced in patients with longstanding diabetes, in patients with diabetic neuropathy, using drugs that block the sympathetic nervous system (e.g., beta-blockers) [see Drug Interactions ( 7 )], or who experience recurrent hypoglycemia. (Insulin degludec label, Warnings and precautions)
- Insulin detemirinsulinModerate
Symptomatic awareness of hypoglycemia may be less pronounced in patients with longstanding diabetes, in patients with diabetic neuropathy, using drugs that block the sympathetic nervous system (e.g., beta-blockers) [see Drug Interactions ( 7 )], or who experience recurrent hypoglycemia. (Insulin detemir label, Warnings and precautions)
Symptomatic awareness of hypoglycemia may be less pronounced in patients with longstanding diabetes, in patients with diabetic neuropathy, using drugs that block the sympathetic nervous system (e.g., beta-blockers) [see Drug Interactions (7) ] , or who experience recurrent hypoglycemia. (Insulin glargine label, Warnings and precautions)
Symptomatic awareness of hypoglycemia may be less pronounced in patients with longstanding diabetes, in patients with diabetic nerve disease, in patients using medications that block the sympathetic nervous system (e.g., beta-blockers) [see Drug Interactions ( 7 )] , or in patients who experience recurrent hypoglycemia. (Insulin lispro label, Warnings and precautions)
- Insulin regular (human)insulinModerate
Symptomatic awareness of hypoglycemia may be less pronounced in patients with longstanding diabetes mellitus, in patients with diabetic nerve disease, in patients using medications that block the sympathetic nervous system (e.g., beta-blockers) [see Drug Interactions ( 7 )], or in patients who experience recurrent hypoglycemia. (Insulin regular (human) label, Warnings and precautions)
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- IsoniazidantibioticModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
- Isradipinedihydropyridine calcium channel blockerModerate
Fentanyl Anesthesia: Severe hypotension has been reported during fentanyl anesthesia with concomitant use of a beta blocker and a calcium channel blocker. (Isradipine label, Drug interactions)
Beta Blockers Nadolol Monitor for adverse reactions. (Itraconazole label, Drug interactions)
- IvabradineModerate
The risk of bradycardia increases with concomitant administration of drugs that slow heart rate (e.g., digoxin, amiodarone, beta-blockers). (Ivabradine label, Drug interactions)
Antivirals indinavir, maraviroc, saquinavir Beta Blockers nadolol Calcium Channel Blockers felodipine, nisoldipine other dihydropyridines, verapamil Calcium channel blockers can have a negative inotropic effect which may be additive to those of ketoconazole. (Ketoconazole label, Drug interactions)
- LacosamideanticonvulsantModerate
VIMPAT should also be used with caution in patients on concomitant medications that affect cardiac conduction, including sodium channel blockers, beta-blockers, calcium channel blockers, potassium channel blockers, and medications that prolong the PR interval [see Drug Interactions (7.2) ] . (Lacosamide label, Warnings and precautions)
- Levalbuterolbeta-adrenergic agonistModerate
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Drug or Drug Class Effect Beta-adrenergic antagonists e.g., Propranolol > 160 mg/day) In patients treated with large doses of propranolol (> 160 mg/day), T 3 and T 4 levels change slightly, TSH levels remain normal, and patients are clinically euthyroid. (Levothyroxine label, Drug interactions)
- LinezolidantibioticModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
- Liothyroninethyroid hormoneModerate
Drug or Drug Class Effect Beta-adrenergic antagonists (e.g., Propranolol >160 mg/day) In patients treated with large doses of propranolol (>160 mg/day), T3 and T4 levels change, TSH levels remain normal, and patients are clinically euthyroid. (Liothyronine label, Drug interactions)
- Lisinopril and hydrochlorothiazideACE inhibitorModerate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- LumateperoneantipsychoticModerate
Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)
Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)
Intervention: During concomitant use of QAMZOVA and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Meloxicam label, Drug interactions)
…(oral): Due to potential inhibition of vitamin K activity by methimazole, the activity of oral anticoagulants (e.g., warfarin) may be increased; additional monitoring of PT/INR should be considered, especially before surgical procedures. β-adrenergic blocking agents: Hyperthyroidism may cause an increased clearance of beta blockers with a high extraction ratio. (Methimazole label, Drug interactions)
Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)
REMERON/REMERONSolTab should be used with caution in patients with known cardiovascular or cerebrovascular disease that could be exacerbated by hypotension (history of myocardial infarction, angina, or ischemic stroke) and conditions that would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medication). (Mirtazapine label, Warnings and precautions)
However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%). (Modafinil label, Warnings and precautions)
( 5.3 Hepatotoxicity) Hypertension: Patients taking some antihypertensive medications may have impaired response to these therapies when taking NSAIDs. (Naproxen label, Warnings and precautions)
- NiacinModerate
Antihypertensive Therapy Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. (Niacin label, Drug interactions)
- Nicardipinedihydropyridine calcium channel blockerModerate
However, titrate slowly when using CARDENE I.V. in combination with a beta-blocker in heart failure patients [see Warnings and Precautions (5.2) ]. (Nicardipine label, Drug interactions)
These responses have usually occurred during initial titration or at the time of subsequent upward dosage adjustment, and may be more likely in patients on concomitant beta blockers. (Nifedipine label, Warnings)
Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)
…of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)
- PaliperidoneantipsychoticModerate
Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)
- PentoxifyllinemethylxanthineModerate
Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)
- PhenelzineMAO inhibitorModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
- Pilocarpinecholinergic agonistModerate
Drug Interactions Pilocarpine should be administered with caution to patients taking beta-adrenergic antagonists because of the possibility of conduction disturbances. (Pilocarpine label, Drug interactions)
Syncopal episodes have usually occurred within 30 to 90 minutes of the initial dose of the drug; occasionally, they have been reported in association with rapid dosage increases or the introduction of another antihypertensive drug into the regimen of a patient taking high doses of prazosin hydrochloride capsules. (Prazosin label, Warnings)
- Propylthiouracilantithyroid drugModerate
Beta-adrenergic blocking agents: Hyperthyroidism may cause an increased clearance of beta blockers with a high extraction ratio. (Propylthiouracil label, Drug interactions)
- Pyridostigminecholinesterase inhibitorModerate
Use with caution in persons with increased risk of anticholinergic reactions, such as persons with bronchial asthma, chronic obstructive pulmonary disease, bradycardia, cardiac arrhythmias, beta blocker treatment (increased risk of anticholinergic reactions). (Pyridostigmine label, Warnings and precautions)
Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)
- RasagilineMAO inhibitorModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
Decrease exposure Beta-blockers Metoprolol Decrease exposure Propranolol Decrease exposure Benzodiazepines Diazepam , Administered with rifampin 1200 mg daily Decrease exposure Benzodiazepine-related drugs Zopiclone Decrease AUC by 82% Zolpidem Decrease AUC by 73% Calcium Channel Blockers Diltiazem Decrease exposure Nifedipine Rifampin 1200 mg administered as… (Rifampin label, Drug interactions)
- RiociguatvasodilatorModerate
Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)
Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)
- Salmeterolbeta-adrenergic agonistModerate
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- SelegilineMAO inhibitorModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
Caution is advised when SILDENAFIL ORAL FILM is co-administered with alpha-blockers or antihypertensives. (Sildenafil label, Warnings and precautions)
- Sofosbuvir and velpatasvirantiviralModerate
Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Sofosbuvir and velpatasvir label, Warnings and precautions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- Spironolactone and hydrochlorothiazidealdosterone antagonistModerate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- Sumatriptan and naproxentriptanModerate
Monitor patients to assure diuretic efficacy including antihypertensive effects. (Sumatriptan and naproxen label, Drug interactions)
• Hypertension: May require antihypertensive therapy; monitor relevant drug interactions. (Tacrolimus label, Warnings and precautions)
- Tasimelteonsedative-hypnoticModerate
Beta-adrenergic Receptor Antagonists (e.g., acebutolol, metoprolol) Beta-adrenergic receptor antagonists have been shown to reduce the production of melatonin via specific inhibition of beta-1 adrenergic receptors. (Tasimelteon label, Drug interactions)
Risk of Hypotension with Concomitant Use of Other Antihypertensive Agents and Phospodiesterase Type 5 Inhibitors (PDE5-I): Concomitant administration of TEZRULY with antihypertensives or phosphodiesterase-5 (PDE-5) inhibitors can result in additive blood pressure lowering effects and symptomatic hypotension (5.3). (Terazosin label, Warnings and precautions)
- Terbutalinebeta-adrenergic agonistModerate
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
In patients with hypertension on antihypertensive therapy, KYZATREX® increased the mean systolic/diastolic BP by 3.4/0.7 mm Hg from baseline after 4 months of treatment and 3.1/1.0 mm Hg from baseline after 6 months of treatment. [see Adverse Reactions (6.1) ]. (Testosterone label, Warnings and precautions)
- TetrabenazineVMAT2 inhibitorModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)
- Triamterenepotassium-sparing diureticModerate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- Umeclidinium and vilanterolanticholinergicModerate
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- ValbenazineVMAT2 inhibitorModerate
Catecholamine depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) may have an additive effect when given with beta-blocking agents. (Metoprolol label, Drug interactions)
- Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
If such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of Metoprolol Tartrate Tablets [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
- VardenafilPDE5 inhibitorModerate
Vardenafil hydrochloride tablets can potentiate the hypotensive effects of nitrates, alpha- blockers, and antihypertensives. (Vardenafil label, Drug interactions)
Caution should be exercised with co-administration of venlafaxine and metoprolol. (Venlafaxine label, Drug interactions)
Concomitant use of glycosides, clonidine, and diltiazem and verapamil with beta-blockers can increase the risk of bradycardia. (Metoprolol label, Drug interactions)
- Vibegronbeta-adrenergic agonistModerate
Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)
Ziprasidone should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Ziprasidone label, Warnings and precautions)
Minor mentions (46)
- AliskirenantihypertensiveMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- Amlodipine and benazeprildihydropyridine calcium channel blockerMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- Azilsartanangiotensin II receptor blocker (ARB)Minor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- ButorphanolopioidMinor
In such cases, butorphanol should be discontinued and the hypertension treated with antihypertensive drugs. (Butorphanol label, Warnings)
- Candesartanangiotensin II receptor blocker (ARB)Minor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- CaptoprilACE inhibitorMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
CNS depressants include: alcohol, opioid analgesics, benzodiazepines, tricyclic antidepressants, sedative/hypnotics, anticonvulsants, antipsychotics, antihistamines, anticholinergics, alpha and beta blockers, general anesthetics, muscle relaxants, and illicit CNS depressants. (Carbamazepine label, Drug interactions)
- ChlorpromazineantipsychoticMinor
Chlorpromazine may counteract the antihypertensive effect of guanethidine and related compounds. (Chlorpromazine label, Warnings)
Pheochromocytoma: Initiate therapy with an alpha blocker. (Metoprolol label, Warnings and precautions)
- Dutasteride and tamsulosin5-alpha reductase inhibitorMinor
Pheochromocytoma: Initiate therapy with an alpha blocker. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Drug Interactions ACE-inhibitors Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Etodolac label, Drug interactions)
…PROSCAR was concomitantly used in clinical studies with acetaminophen, acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines,… (Finasteride label, Drug interactions)
- FingolimodimmunosuppressantMinor
Drugs That Slow Heart Rate or Atrioventricular Conduction (e.g., beta blockers or diltiazem) Experience with GILENYA in patients receiving concurrent therapy with drugs that slow the heart rate or AV conduction (e.g., beta blockers, digoxin, or heart rate-slowing calcium channel blockers, such as diltiazem or verapamil) is limited. (Fingolimod label, Drug interactions)
- FosinoprilACE inhibitorMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- Glyburide and metforminsulfonylureaMinor
Examples: Nonsteroidal anti-inflammatory agents and other highly protein-boind drugs, salicylcates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, beta-adrenergic blocking agents; potentially with ciprofloxacin, micronazole. (Glyburide and metformin label, Drug interactions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- Isosorbide dinitrate and hydralazinenitrateMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE inhibitors and/or angiotensin II receptor antagonists. (Ketorolac label, Drug interactions)
Pheochromocytoma: Initiate therapy with an alpha blocker. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- Lofexidinealpha-adrenergic agonistMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- MethyldopaantihypertensiveMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- MoexiprilACE inhibitorMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Drug Interactions: ACE-inhibitors: Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Nabumetone label, Drug interactions)
- Nadololbeta blockerMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- Nisoldipinedihydropyridine calcium channel blockerMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- PerindoprilACE inhibitorMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- Pindololbeta blockerMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concomitantly. (Prochlorperazine label, Precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Pheochromocytoma: Initiate therapy with an alpha blocker. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
- TrandolaprilACE inhibitorMinor
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)
No significant interaction reported (2)
- DesvenlafaxineSNRINo interaction
Examples desipramine, atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine 7.2 Drugs Having No Clinically Important Interactions with PRISTIQ Based on pharmacokinetic studies, no dosage adjustment is required for drugs that are mainly metabolized by CYP3A4 (e.g., midazolam), or for drugs that are metabolized by both CYP2D6 and CYP3A4… (Desvenlafaxine label, Drug interactions)
- Sevelamerphosphate binderNo interaction
Table 5: Sevelamer Drug Interactions Oral drugs for which sevelamer did not alter the pharmacokinetics when administered concomitantly Digoxin Enalapril Iron Metoprolol Warfarin Oral drugs that have demonstrated interaction with sevelamer and are to be dosed separately from sevelamer carbonate Dosing Recommendations Ciprofloxacin Take at least 2 hours before… (Sevelamer label, Drug interactions)
Check Metoprolol against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.