Metoprolol and Nifedipine interaction

Metoprolol and Nifedipine: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Nifedipine (Procardia XL) label · effective 2025-12-16

Moderate

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.

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Moderate

Severe hypotension and/or increased fluid volume requirements have been reported in patients receiving nifedipine together with a beta-blocking agent who underwent coronary artery bypass surgery using high dose fentanyl anesthesia.

Warningsby drug classView label on DailyMed
Moderate

The interaction with high dose fentanyl appears to be due to the combination of nifedipine and a beta blocker, but the possibility that it may occur with nifedipine alone, with low doses of fentanyl, in other surgical procedures, or with other narcotic analgesics cannot be ruled out.

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Moderate

Patients recently withdrawn from beta blockers may develop a withdrawal syndrome with increased angina, probably related to increased sensitivity to catecholamines.

Warningsby drug classView label on DailyMed
Moderate

Drug Interactions Beta-adrenergic blocking agents (see INDICATIONS AND USAGE and WARNINGS ) Experience in over 1400 patients with PROCARDIA capsules in a noncomparative clinical trial has shown that concomitant administration of nifedipine and beta-blocking agents is usually well tolerated, but there have been occasional literature reports suggesting that the…

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From the Metoprolol (Metoprolol Tartrate) label · effective 2026-01-29

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.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.