Drug interactions
Bisoprolol + Metoprolol
Severity: Major
Bisoprolol and Metoprolol: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are beta1-selective blockers, so using them together provides no added benefit and increases the risk of bradycardia, hypotension and AV block.
What this interaction means in plain words
Bisoprolol and Metoprolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Bisoprolol belongs to Cardiovascular; Metoprolol belongs to Cardiovascular.
Why it happens
Additive beta1-adrenergic receptor blockade.
What to do
Avoid combined use and keep one beta-blocker at an optimized dose. If both are taken, stop one and monitor heart rate and blood pressure.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Bisoprolol
Other interactions of Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol Major
Frequently asked questions
Can I take Bisoprolol with Metoprolol?
MediHelp rates the interaction as major. Bisoprolol and Metoprolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are beta1-selective blockers, so using them together provides no added benefit and increases the risk of bradycardia, hypotension and AV block.
How serious is the interaction between Bisoprolol and Metoprolol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combined use and keep one beta-blocker at an optimized dose. If both are taken, stop one and monitor heart rate and blood pressure.
What other medicines interact with Bisoprolol?
MediHelp also lists interactions of Bisoprolol with, for example, Aldesleukin, Amifostine, Amiodarone. The full list is on the Bisoprolol page.
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