Drug interactions
Dronedarone + Metoprolol
Severity: Major
Dronedarone and Metoprolol: major interaction.
Last updated Sources: US FDA label
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
Dronedarone inhibits CYP2D6 and raises metoprolol exposure, and it also slows heart rate and AV conduction. The combination can cause pronounced bradycardia, AV block and hypotension.
What this interaction means in plain words
Dronedarone 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.
Dronedarone belongs to Cardiovascular; Metoprolol belongs to Cardiovascular.
Why it happens
Dronedarone inhibition of CYP2D6 plus additive negative chronotropic and dromotropic effects.
What to do
Start with a low metoprolol dose and monitor ECG and heart rate. Reduce the beta-blocker dose if bradycardia or conduction delay develops.
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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References
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 Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Frequently asked questions
Can I take Dronedarone with Metoprolol?
MediHelp rates the interaction as major. Dronedarone 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. Dronedarone inhibits CYP2D6 and raises metoprolol exposure, and it also slows heart rate and AV conduction. The combination can cause pronounced bradycardia, AV block and hypotension.
How serious is the interaction between Dronedarone 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: Start with a low metoprolol dose and monitor ECG and heart rate. Reduce the beta-blocker dose if bradycardia or conduction delay develops.
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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