4 known interactions • 1 major • 2 moderate • 1 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Verapamil / Diltiazem (non-dihydropyridine CCBs)
Combined negative chronotropic and dromotropic effects can cause severe bradycardia, heart block, and hemodynamic compromise, particularly with IV verapamil.
Management: Avoid combination or use extreme caution; do not give IV verapamil to patients on beta-blockers.
Clonidine
If clonidine is abruptly discontinued while patient is on beta-blocker, rebound hypertension can occur. Beta-blocker may mask symptoms.
Management: Taper clonidine gradually; stop beta-blocker first if both are being discontinued.
Insulin / Oral antidiabetics
Beta-blockers mask tachycardia (a key warning sign of hypoglycemia) in diabetics. May also prolong hypoglycemia.
Management: Educate patient; check glucose by fingerstick rather than relying on symptoms.
NSAIDs
Chronic NSAID use may attenuate antihypertensive effect of beta-blockers.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Metoprolol. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.