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Toprol XL


Selected Beta-Blockers/Amiodarone; Dronedarone

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Amiodarone and dronedarone may decrease the ability of your liver to remove some beta-blockers.

What might happen:

The levels of your beta-blocker in your body may cause your blood pressure to decrease too much. Symptoms of low blood pressure include: dizziness, weakness, irregular heartbeat, nausea, drowsiness, confusion, and slurred speech.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to change the dose of your beta-blocker or change you to a different beta-blocker. Let your doctor know right away if you develop dizziness, weakness, blurred vision, or low blood pressure.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.


1.Leor J, Levartowsky D, Sharon C, Farfel Z. Amiodarone and beta-adrenergic blockers: an interaction with metoprolol but not with atenolol. Am Heart J 1988 Jul;116(1 Pt 1):206-7.

2.Multaq (dronedarone) US prescribing information. Sanofi-Aventis U.S. LLC January, 2014.

3.Derrida JP, Ollagnier J, Benaim R, Haiat R, Chiche P. Amiodarone and propanolol: a dangerous combination?. Nouv Presse Med 1979 Apr 14; 8(17):1429.

4.Fukumoto K, Kobayashi T, Komamura K, Kamakura S, Kitakaze M, Ueno K. Stereoselective effect of amiodarone on the pharmacokinetics of racemic carvedilol. Drug Metab Pharmacokinet 2005 Dec;20(6):423-7.

5.Nagele H, Bohlmann M, Eck U, Petersen B, Rodiger W. Combination therapy with carvedilol and amiodarone in patients with severe heart failure. Eur J Heart Fail 2000 Mar;2(1):71-9.

6.Macdonald PS, Keogh AM, Aboyoun C, Lund M, Amor R, McCaffrey D. Impact of concurrent amiodarone treatment on the tolerability and efficacy of carvedilol in patients with chronic heart failure. Heart 1999 Nov; 82(5):589-93.

7.Krum H, Shusterman N, MacMahon S, Sharpe N. Efficacy and safety of carvedilol in patients with chronic heart failure receiving concomitant amiodarone therapy. Australia/New Zealand Heart Failure Research Collaborative Group. J Card Fail 1998 Dec;4(4):281-8.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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