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| __NOTOC__
| | #REDIRECT [[Metoprolol succinate#Drug Interactions]] |
| {{Metoprolol}}
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| {{CMG}}
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| ====Catecholamine Depleting Drugs====
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| [[Catecholamine]] depleting drugs (eg, [[reserpine]], [[monoamine oxidase]] (MAO) inhibitors) may have an additive effect when given with [[beta-blocking agent]]s. Observe patients treated with TOPROL-XL plus a [[catecholamine]] depletor for evidence of [[hypotension]] or marked [[bradycardia]], which may produce [[vertigo]], [[syncope]], or [[postural hypotension]]. | |
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| ====CYP2D6 Inhibitors====
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| Drugs that inhibit [[CYP]]2D6 such as [[quinidine]], [[fluoxetine]], [[paroxetine]], and propafenone are likely to increase metoprolol concentration. In healthy subjects with CYP2D6 extensive metabolizer phenotype, coadministration of quinidine 100 mg and immediate-release metoprolol 200 mg tripled the concentration of S-metoprolol and doubled the metoprolol elimination half-life. In four patients with cardiovascular disease, coadministration of propafenone 150 mg t.i.d. with immediate-release metoprolol 50 mg t.i.d. resulted in two- to five-fold increases in the steady-state concentration of metoprolol. These increases in plasma concentration would decrease the cardioselectivity of metoprolol.
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| ====Digitalis, Clonidine, and Calcium Channel Blockers====
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| Digitalis glycosides, clonidine, diltiazem and verapamil slow atrioventricular conduction and decrease heart rate. Concomitant use with beta blockers can increase the risk of bradycardia.
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| If clonidine and a beta blocker, such as metoprolol are coadministered, withdraw the beta-blocker several days before the gradual withdrawal of clonidine because beta-blockers may exacerbate the rebound hypertension that can follow the withdrawal of clonidine. If replacing clonidine by beta-blocker therapy, delay the introduction of beta-blockers for several days after clonidine administration has stopped [see Warnings and Precautions (5.11)].<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = TOPROL XL (METOPROLOL SUCCINATE) TABLET, EXTENDED RELEASE [BRYANT RANCH PREPACK] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=01038198-b4f0-41f3-9a9c-5c84e5a0d3b9 | publisher = | date = | accessdate = }}</ref>
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| ==References==
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| {{Reflist}}
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| {{FDA}}
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| [[Category:Beta blockers]]
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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