Drug interactions
Cocaine + Metoprolol
Severity: Moderate
Cocaine and Metoprolol: moderate 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
Blocking beta receptors in a person exposed to cocaine can leave alpha-adrenergic vasoconstriction unopposed. This may worsen hypertension and coronary vasospasm, risking angina or ischemia. With topical cocaine, systemic exposure is lower, so the risk is smaller but not nil.
What this interaction means in plain words
Cocaine and Metoprolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cocaine belongs to Central Nervous System; Metoprolol belongs to Cardiovascular.
Why it happens
Unopposed alpha-adrenergic vasoconstriction after beta blockade during cocaine-induced sympathetic stimulation.
What to do
Avoid cocaine use in patients on beta-blockers; if topical cocaine is required medically, use the minimum dose and monitor blood pressure and ECG.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol Major
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Metoprolol?
MediHelp rates the interaction as moderate. Cocaine and Metoprolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Blocking beta receptors in a person exposed to cocaine can leave alpha-adrenergic vasoconstriction unopposed. This may worsen hypertension and coronary vasospasm, risking angina or ischemia. With topical cocaine, systemic exposure is lower, so the risk is smaller but not nil.
How serious is the interaction between Cocaine and Metoprolol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid cocaine use in patients on beta-blockers; if topical cocaine is required medically, use the minimum dose and monitor blood pressure and ECG.
What other medicines interact with Metoprolol?
MediHelp also lists interactions of Metoprolol with, for example, Thioridazine, Amifostine, Amiodarone. The full list is on the Metoprolol page.
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