Hypetor Drug Interactions

Concurrent administration of metoprolol and insulin or oral hypoglycemic agents, their effect may be intensified. The symptoms of reduced blood sugar concentration in particular, accelerated pulse is masked or moderated. Regular blood sugar checks are therefore necessary. Metoprolol can intensify the effect of currently administered antihypertensive medications (particular caution is advised with prazosin). With concurrent administration of nitroglycerine or nifedipine-type calcium antagonist, a stronger drop in blood pressure may occur. With concurrent administration of Verapamil or diltiazem-type calcium antagonists or other anti-arrhythmic agents, careful monitoring of the patient is indicated, as fall in blood pressure, slowing the pulse rate or other cardiac irregularities may occur. During therapy of metoprolol, the IV administration of calcium antagonists or other anti-arrhythmic agents should be avoided. With concurrent administration of adrenaline or other substances with symphathomimetic action (eg. contained in cough mixtures nasal and eye drops), cardioselective β-blockers in therapeutic doses result in lower hypertensive reactions than non-selective β-blockers. With concurrent administration of metoprolol and reserpine, alpha-methyldopa, clonidine guanfacine or cardiac glycosides, there may be stronger drop in cardiac frequency or a delay in stimulus conduction in the heart.
With concurrent therapy with clonidine, clonidine may not be discontinued until several days after the discontinuation of the administration of metoprolol. Rifampicin lowers while cimetidine increases the plasma concentration of metoprolol. Indomethacin may reduce the hypotensive effect of metoprolol. The elimination of other medications may be reduced by metoprolol (eg. lidocaine). The sedative effects of metoprolol and alcohol may be reciprocally intensified. The effects of metoprolol and an anesthetic in reducing the force of myocardial contraction may be compounded. For this reason, the anesthetist should be notified of therapy with metoprolol.