Metoprolol/Selected CYP2D6 Inhibitors Interactions

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:

Some medicines may slow down how quickly your body processes metoprolol.

What might happen:

The amount of metoprolol in your blood may increase and cause more side effects than normal.

What you should do about this interaction:

Let your healthcare professionals (e.g doctor or pharmacist) know that you are taking these medicines together. Let your doctor know if you experience a slow heartbeat, weakness, fatigue, or dizziness. Your medicine may need to be adjusted.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.Lopressor (metoprolol tartrate) US prescribing information. Validus Pharmaceuticals. LLC March, 2013.
  • 2.Toprol-XL (metoprolol succinate) US prescribing information. AstraZeneca LP March, 2011.
  • 3.Varubi (rolapitant) US prescribing information. Tesaro Inc. March, 2018. 4.Celexa (citalopram hydrobromide) US prescribing information. Forest Laboratories Inc. January, 2019.
  • 4.Preskorn SH, Greenblatt DJ, Flockhart D, Luo Y, Perloff ES, Harmatz JS, Baker B, Klick-Davis A, Desta Z, Burt T. Comparison of duloxetine, escitalopram, and sertraline effects on cytochrome P450 2D6 function in healthy volunteers. J Clin Psychopharmacol 2007 Feb;27(1):28-34.
  • 5.Spahn H, Mutschler E, Kirch W, Ohnhaus EE, Janisch HD. Influence of ranitidine on plasma metoprolol and atenolol concentrations. Br Med J (Clin Res Ed) 1983 May 14;286(6377):1546-7.
  • 6.Kelly JG, Salem SA, Kinney CD, Shanks RG, McDevitt DG. Effects of ranitidine on the disposition of metoprolol. Br J Clin Pharmacol 1985 Feb; 19(2):219-24.
  • 7.Kirch W, Ramsch K, Janisch HD, Ohnhaus EE. The influence of two histamine H2-receptor antagonists, cimetidine and ranitidine, on the plasma levels and clinical effect of nifedipine and metoprolol. Arch Toxicol Suppl 1984; 7:256-9.
  • 8.Mutschler E, Spahn H, Kirch W. The interaction between H2-receptor antagonists and beta-adrenoceptor blockers. Br J Clin Pharmacol 1984;17 Suppl 1:51S-57S.
  • 9.Toon S, Davidson EM, Garstang FM, Batra H, Bowes RJ, Rowland M. The racemic metoprolol H2-antagonist interaction. Clin Pharmacol Ther 1988 Mar;43(3):283-9.
  • 10.Ranexa (ranolazine) US prescribing information. Gilead January, 2016. 12.Phansalkar S, van der Sijs H, Tucker AD, Desai AA, Bell DS, Teich JM, Middleton B, Bates DW. Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Inform Assoc 2012 Sep 25.

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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.