How does metoprolol interact with other medications. What are the major, moderate, and minor drug interactions for metoprolol. How can patients safely use metoprolol with other medicines.

Understanding Metoprolol and Its Interactions

Metoprolol is a widely prescribed medication belonging to the class of drugs known as beta-blockers. It’s primarily used to treat high blood pressure, angina, and certain heart rhythm disorders. However, like many medications, metoprolol can interact with other drugs, alcohol, food, and certain medical conditions. Understanding these interactions is crucial for ensuring the safe and effective use of this medication.

Key Facts About Metoprolol Interactions

• There are 503 known drug interactions with metoprolol
• 19 disease interactions have been identified
• 4 alcohol/food interactions exist
• Of the drug interactions, 26 are major, 440 are moderate, and 37 are minor

Major Drug Interactions with Metoprolol

Major drug interactions are considered highly clinically significant and should generally be avoided due to the potential risks outweighing the benefits. Some of the medications that have major interactions with metoprolol include:

• Certain antiarrhythmic drugs
• Some calcium channel blockers
• Specific MAO inhibitors
• Particular antipsychotic medications

Why are these interactions considered major? In many cases, combining metoprolol with these medications can lead to severe bradycardia (slowed heart rate), hypotension (low blood pressure), or other cardiovascular complications. Healthcare providers must carefully weigh the risks and benefits before prescribing metoprolol alongside any of these drugs.

Moderate Drug Interactions: Proceed with Caution

The majority of metoprolol’s drug interactions fall into the moderate category. These interactions are still clinically significant and often require careful monitoring or dosage adjustments. Some common medications with moderate interactions include:

• Aspirin and other NSAIDs
• Certain antidepressants
• Some diabetes medications
• Various blood thinners

How should patients handle moderate interactions? While these interactions don’t necessarily rule out the use of both medications, they do require close supervision by a healthcare provider. Patients may need regular check-ups, blood tests, or dosage adjustments to ensure both medications can be used safely and effectively.

Minor Drug Interactions: Awareness is Key

Minor drug interactions with metoprolol are generally considered to have minimal clinical significance. However, it’s still important for patients and healthcare providers to be aware of them. Some examples include:

• Certain vitamins and supplements
• Some over-the-counter allergy medications
• Particular gastrointestinal drugs

While these interactions are less likely to cause serious problems, patients should still inform their healthcare providers about all medications and supplements they’re taking, including those available over the counter.

Alcohol and Food Interactions with Metoprolol

Metoprolol has four known alcohol/food interactions. These interactions can affect how the medication works in the body or increase the risk of side effects. Patients should be aware of the following:

• Alcohol consumption may increase the blood pressure-lowering effects of metoprolol
• Certain foods high in tyramine can interact with metoprolol
• Grapefruit and grapefruit juice may increase the concentration of metoprolol in the blood
• High-fat meals can affect the absorption of certain formulations of metoprolol

How can patients manage these interactions? It’s best to discuss alcohol consumption with a healthcare provider when taking metoprolol. Regarding food interactions, patients should follow their doctor’s advice on dietary restrictions and be consistent with their eating habits while on this medication.

Disease Interactions: When Medical Conditions Matter

Metoprolol has 19 known disease interactions. These are situations where the medication may need to be used with caution or avoided altogether due to certain medical conditions. Some of the most significant disease interactions include:

• Bradyarrhythmia/AV block
• Cardiogenic shock/hypotension
• Congestive heart failure (CHF)
• Diabetes
• Liver disease
• Asthma/COPD

Why are these disease interactions important? In some cases, metoprolol can exacerbate existing medical conditions or interfere with their management. For example, in patients with asthma or COPD, metoprolol can potentially worsen breathing difficulties. In diabetics, it may mask some of the symptoms of low blood sugar.

Navigating Metoprolol Use Safely

Given the numerous potential interactions associated with metoprolol, how can patients ensure they’re using this medication safely? Here are some key strategies:

1. Always provide a complete medication list to healthcare providers
2. Inform doctors about all medical conditions, even those that seem unrelated
3. Don’t start or stop any medications (including over-the-counter drugs and supplements) without consulting a healthcare provider
4. Be aware of potential side effects and report any unusual symptoms promptly
5. Follow dosing instructions carefully and don’t adjust the dose without medical advice

Can patients take other medications safely with metoprolol? In many cases, yes, but it often requires careful management and monitoring by healthcare professionals. The key is open communication and adherence to medical advice.

Special Considerations for Metoprolol Use

Beyond interactions, there are several other factors patients should be aware of when taking metoprolol:

Pregnancy and Breastfeeding

Metoprolol is generally considered pregnancy category C, meaning that risk cannot be ruled out. It’s also known to pass into breast milk. Women who are pregnant, planning to become pregnant, or breastfeeding should discuss the risks and benefits of metoprolol use with their healthcare provider.

Elderly Patients

Older adults may be more sensitive to the effects of metoprolol, particularly its blood pressure-lowering effects. Dosage adjustments may be necessary, and closer monitoring is often required.

Surgery and Dental Procedures

Patients taking metoprolol should inform their surgeon or dentist before any procedures. In some cases, the medication may need to be temporarily stopped or the dose adjusted.

How should patients prepare for surgery while on metoprolol? It’s crucial to discuss medication management with both the surgeon and the prescribing physician well in advance of any planned procedures.

Monitoring and Managing Metoprolol Therapy

Effective use of metoprolol often involves ongoing monitoring and management. This may include:

• Regular blood pressure checks
• Periodic blood tests to check kidney and liver function
• Heart rate monitoring
• Assessment of side effects and overall medication effectiveness

What should patients expect during follow-up appointments for metoprolol? These visits typically involve reviewing blood pressure readings, discussing any side effects or concerns, and potentially adjusting the dosage if needed.

Patients should also be aware of signs that may indicate a need for immediate medical attention, such as:

• Chest pain or severe dizziness
• Shortness of breath or wheezing
• Swelling of the hands, feet, or ankles
• Unusually slow or irregular heartbeat

By staying informed about these potential issues and maintaining open communication with healthcare providers, patients can help ensure the safe and effective use of metoprolol.

Alternative Treatments and Complementary Therapies

While metoprolol is an effective medication for many patients, some may explore alternative or complementary treatments. These might include:

• Other classes of blood pressure medications
• Lifestyle modifications such as diet and exercise
• Stress reduction techniques like meditation or yoga
• Herbal supplements (though these should be used cautiously due to potential interactions)

Is it safe to use complementary therapies alongside metoprolol? Some complementary approaches can be used safely in conjunction with metoprolol, but it’s crucial to discuss any planned changes or additions to treatment with a healthcare provider. This ensures that all aspects of care are coordinated and potential interactions are minimized.

Patients should be particularly cautious about using herbal supplements or alternative medicines without medical advice, as these can sometimes interact with metoprolol or interfere with its effectiveness.

The Future of Metoprolol Use and Research

As medical research continues to advance, our understanding of metoprolol and its interactions is likely to evolve. Some areas of ongoing research include:

• Personalized medicine approaches to optimize metoprolol dosing
• Investigation of new formulations or delivery methods
• Studies on long-term effects and potential new uses for metoprolol
• Research into minimizing side effects and interactions

How might future developments affect metoprolol use? As we gain more knowledge about genetic factors influencing drug responses, we may see more tailored approaches to prescribing metoprolol. This could potentially help reduce the risk of interactions and improve overall treatment outcomes.

Patients currently taking metoprolol should stay informed about new developments but should not make changes to their treatment based on preliminary research findings without consulting their healthcare provider.

In conclusion, while metoprolol is a valuable medication for many patients, its numerous potential interactions underscore the importance of careful management and open communication with healthcare providers. By staying informed and following medical advice, patients can help ensure they receive the maximum benefit from metoprolol while minimizing risks.

Metoprolol Interactions Checker – Drugs.com

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There are 503 drugs known to interact with
metoprolol, along with
19 disease interactions, and 4 alcohol/food interactions.

Of the total drug interactions,
26 are major, 440 are moderate, and 37 are minor.

Does metoprolol interact with my other drugs?

Enter other medications to view a detailed report.

• View all 503 medications that may interact with metoprolol
• View metoprolol alcohol/food interactions (4)
• View metoprolol disease interactions (19)

Most frequently checked interactions

View interaction reports for metoprolol and the medicines listed below.

• Major
• Moderate
• Minor
• Unknown

• Advair Diskus (fluticasone / salmeterol)
• Aspir 81 (aspirin)
• Aspirin Low Strength (aspirin)
• Benadryl (diphenhydramine)
• CoQ10 (ubiquinone)
• Coumadin (warfarin)
• Crestor (rosuvastatin)
• Cymbalta (duloxetine)
• Eliquis (apixaban)
• Fish Oil (omega-3 polyunsaturated fatty acids)
• Lantus (insulin glargine)
• Lasix (furosemide)
• Lexapro (escitalopram)
• Lipitor (atorvastatin)
• Lyrica (pregabalin)
• Nexium (esomeprazole)
• Norco (acetaminophen / hydrocodone)
• Plavix (clopidogrel)
• Protonix (pantoprazole)
• Singulair (montelukast)
• Synthroid (levothyroxine)
• Tylenol (acetaminophen)
• Vitamin B12 (cyanocobalamin)
• Vitamin C (ascorbic acid)
• Vitamin D2 (ergocalciferol)
• Vitamin D3 (cholecalciferol)
• Xanax (alprazolam)
• Xarelto (rivaroxaban)
• Zoloft (sertraline)
• Zyrtec (cetirizine)

Metoprolol alcohol/food interactions

There are 4 alcohol/food interactions with metoprolol.

Metoprolol disease interactions

There are 19 disease interactions with metoprolol which include:

• bradyarrhythmia/AV block
• cardiogenic shock/hypotension
• CHF
• diabetes
• hemodialysis
• hypersensitivity
• ischemic heart disease
• PVD
• liver disease
• cerebrovascular insufficiency
• glaucoma
• hyperlipidemia
• hyperthyroidism
• hyperthyroidism PKs
• myasthenia gravis
• pheochromocytoma
• psoriasis
• tachycardia
• asthma/COPD

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More about metoprolol

• metoprolol consumer information
• Compare alternatives
• Reviews (628)
• Drug images
• Side effects
• Dosage information
• Patient tips
• During pregnancy
• Support group
• Drug class: cardioselective beta blockers
• Breastfeeding
• En español

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Metoprolol Pill Images – What does metoprolol look like?

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What does Metoprolol tartrate look like?

Note: Multiple pictures are displayed for those medicines available in different strengths, marketed under different brand names and for medicines manufactured by different pharmaceutical companies. Multi ingredient medications may also be listed when applicable.
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What helps, analogs, prescription, dosage, mechanism of action

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED.

Podoinitsyna Alena Andreevna,

Diploma in Pharmaceutical Education: 105924 3510722 reg. number 31917

All authors

Content of the article

• Metoprolol: mechanism of action
• Metoprolol: from what
• Metoprolol: prescription
• Metoprolol: dosage
• Metoprolol: analogues
• Metoprolol or Egilok: which is better
• Anaprilin or Metoprolol: which is better
• Summary
• Ask an expert on the topic of the article

Hypertension is a chronic disease, the main manifestation of which is an increase in blood pressure. High blood pressure is responsible for 10 million deaths and 200 million disabilities worldwide. Symptoms of hypertension are either absent or nonspecific: headache, dizziness, palpitations.

Hypertension can and should be treated and controlled with medicines. We asked the pharmacist Alena Podoinitsyna to tell us about the drug Metoprolol: what it is prescribed for, in what dosages it is produced and what is the mechanism of action of the drug. They gave several examples of analogues of Metoprolol, and also compared it with Egilok and Anaprilin.

All products Metoprolol

20 reviews

Metoprolol: mechanism of action

Metoprolol is a medicine that is taken for high blood pressure. The drug blocks beta-adrenergic receptors. Blockade of beta-adrenergic receptors leads to a decrease in the number of heart contractions, contractility and speed of contraction of the heart muscle, while reducing myocardial oxygen demand.

Metoprolol: from what

We understand what Metoprolol tablets are from. The drug has antihypertensive, antianginal and antiarrhythmic effects. Metoprolol is a beta-blocker. It helps to reduce pressure at rest, during stress and physical exertion.

Antianginal effect is manifested in a decrease in heart rate and a decrease in the heart’s need for oxygen. The antiarrhythmic effect is expressed in the elimination of tachycardia, a decrease in the excitability of the heart and the conduction of nerve impulses in its tissues.

Metoprolol: indications for use

• high blood pressure
• angina pectoris
• complex therapy after a heart attack
• arrhythmia, tachycardia
• migraine prophylaxis
• hyperthyroidism

Prescription metoprolol

Metoprolol is a prescription drug. When buying it, a pharmacy employee will ask you to provide a prescription from a doctor. The drug is available by prescription, as when used in recommended doses, the patient can harm himself.

Metoprolol has side effects and contraindications. Only a doctor can evaluate the benefit-risk ratio of the drug. Therefore, the decision on the need for his appointment is also made by the doctor.

Metoprolol: contraindications for use

• hypersensitivity to any component of the preparation
• atrioventricular block II and III degree
• heart failure in the stage of decompensation
• patient therapy with nootropics acting on beta-adrenergic receptors
• decrease in heart rate below 60 beats per minute
• cardiogenic shock
• circulatory disorders in the organs, or the threat of gangrene
• low blood pressure
• acute myocardial infarction
• lactose intolerance, glucose-galactose malabsorption
• children under 18 years of age
• severe form of bronchial asthma and chronic obstructive pulmonary disease.
• concomitant use of certain groups of drugs
• lactation

Metoprolol: dosage

Metoprolol contains the active ingredient: metoprolol tartrate, at a dosage of 100 mg per 1 tablet. But we note that Metoprolol is produced on the basis of 2 active ingredients, or rather, salts. Each of them carries an action peculiar only to it.

• Metoprolol tartrate – the substance is contained in tablets of immediate action, these tablets must be taken several times a day.
• Metoprolol succinate – the substance is contained in tablets with a delayed release, respectively, such tablets are drunk 1 time per day.

Metoprolol: analogues

In order to choose metoprolol analogues and substitutes, a specialist consultation is necessary. Egilok, Serdol, Metocard, Betalok, Betalok ZOK contain metoprolol as an active substance. Metoprolol can be replaced with them without consulting a doctor. We recommend that you consult with a pharmacy employee or a pharmacist in the chat on our service. The specialist will help you choose the right dosage and dosage form.

The need to change to drugs with a different active substance is determined by the doctor. Metoprolol is part of the combined preparations. For example, Logimax, Implicor, Hypotef. They, in addition to metoprolol, contain other active ingredients. You can not replace them with a simple Metoprolol.

Do you want to understand the analogues of drugs in order to skillfully select drugs for your budget? Our manual from expert pharmacists “Analogues of popular drugs” will help you with this! Getting a training manual is easy: subscribe to our social networks and write “analogues” in the messages.

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Metoprolol or Egilok: which is better

When choosing the best drug, you should first consult with your doctor. There are practically no differences between Metoprolol and Egilok. Preparations differ by manufacturers:

• Metoprolol is produced in Russia, Slovenia, Israel, Slovakia and Germany
• Egilok is produced only in Hungary.

Other characteristics, such as: mechanism of action, indications for use, contraindications, side effects and other special indications, are the same for both drugs. All characteristics depend on the active substance. In both preparations, it is metoprolol tartrate. Therefore, Egilok is a substitute for Metoprolol.

Anaprilin or Metoprolol: which is better

Both drugs belong to the same group of drugs – beta-blockers. But the active ingredients are different. Anaprilin contains propranolol hydrochloride.

The difference between active substances lies in the mechanism of their action.

• Metoprolol is a non-selective adrenoblocker and acts on beta1-adrenergic receptors
• Anaprilin is selective and acts on beta1- and beta2-adrenergic receptors.

Thus, Anaprilin has more side effects and contraindications than Metoprolol. For example: both drugs should be taken with caution in diabetes mellitus. Metoprolol is also with caution in: chronic obstructive pulmonary disease and bronchial asthma, and Anaprilin is completely contraindicated.

Preparations and manufacturers differ.

• Anaprilin is produced by Russia and Ukraine
• Metoprolol is produced by Russia and 4 other countries.

Follow your doctor’s advice to select the best drug.

All products Egilok

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All products Anaprilin

21 reviews

Summary

• Metoprolol is an antihypertensive drug that is often prescribed for the treatment of hypertension, coronary heart disease and arrhythmias.
• Metoprolol is a prescription drug and is available only on prescription.
• The active substance of metoprolol is the salt of metoprolol succinate or tartrate.
• Metoprolol lowers blood pressure by reducing the heart’s need for oxygen and reducing the heart rate.
• Metoprolol has 4 analogues with which it can be substituted.
• When comparing Metoprolol with Egilok, differences were found only in manufacturers.
• Anaprilin differs from Metoprolol not only in producing companies, but also in the active substance.

Ask an expert about the topic of the article

Still have questions? Ask them in the comments below and our experts will answer you. There you can also share your experience with other readers of Megasovets.

Managing editor

Zotina Natalya Igorevna,

Expert pharmacist

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