Metoprolol 100 Stada Drug Interactions

The following interactions between the metoprolol and other substances should be noted.
With concurrent administration of metoprolol and insulin or oral hypoglycemic agents, their effect may be intensified; the symptoms of reduced blood sugar concentration (hypoglycaemia). In particular accelerated pulse (tachycardia) are masked or moderated. Regular blood sugar checks are therefore necessary.
Metoprolol can intensify the effect of concurrently administered anti-hypertensive medications (particular caution advised with prazosin). With concurrent administration of nitroglycerin of nifedipine-type calcium antagonists, a stronger drop in blood pressure may occur. With concurrent administration of verapamil of diltiazem-type calcium antagonists or other anti-arrhrythmic agents, careful monitoring of the patient is indicated, as fall in blood pressure (hypotension), slowing of the pulse rate (bradycardia) or other cardiac irregularities may occur. During therapy with metoprolol, the intravenous administration of calcium antagonists or other anti-arrhythmic agents should therefore be avoided.
With concurrent administration of adrenaline or other substances with a sympathomimetic action (e.g. contained in cough mixtures, nasal and eye drops), cardioselective beta-blockers in therapeutic doses result in lower hypertensive reactions than non-selective beta-blockers. With concurrent administration of metoprolol and reserpine, alpha-methyldopa, clonidine, guanfacine or cardiac glycosides, there may be a 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 and cimetidine increases the plasma concentration of metoprolol.
Indomethacin may reduce the hypotensive affect of metoprolol.
The elimination of other medications may be reduced by Metoprolol (e.g. lidocaine).
The sedative effects of metoprolol and alcohol may be reciprocally instensified.
The effect of metroprolol and an anaesthetic in reducing the force of myocardial contraction may be compounded. For this reason, the anesthetist should be notified of therapy with Metoprolol 100 Stada.