Metoprolol and Quinidine interaction

Metoprolol and Quinidine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

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

Major

CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided.

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Moderate

CYP2D6 Inhibitors are likely to increase metoprolol concentration.

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Minor

Drugs that are strong inhibitors of CYP2D6 such as quinidine, fluoxetine, paroxetine, and propafenone were shown to double metoprolol concentrations.

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From the Quinidine (Quinidine Gluconate) label · effective 2024-08-27

Minor

The effects (if any) of coadministration of other β-blockers on quinidine pharmacokinetics have not been adequately studied.

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No interaction

Non-interactions of quinidine with other drugs: Quinidine has no clinically significant effect on the pharmacokinetics of diltiazem, flecainide, mephenytoin, metoprolol, propafenone, propranolol, quinine, timolol, or tocainide .

Drug interactionsnames MetoprololView label on DailyMed
No interaction

Coadministration of propranolol usually does not affect quinidine pharmacokinetics, but in some studies the β-blocker appeared to cause increases in the peak serum levels of quinidine, decreases in quinidine's volume of distribution, and decreases in total quinidine clearance.

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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.