Drug interactions
Epinephrine + Metoprolol
Severity: Moderate
Epinephrine 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
Beta-blockade blunts the cardiac and bronchodilator effects of epinephrine, reducing its benefit in anaphylaxis. With a cardioselective agent such as metoprolol, unopposed alpha-adrenergic stimulation may still cause hypertension with reflex bradycardia, particularly at higher doses.
What this interaction means in plain words
Epinephrine 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.
Epinephrine belongs to Endocrine; Metoprolol belongs to Cardiovascular.
Why it happens
Pharmacodynamic antagonism at beta-adrenergic receptors, with unopposed alpha-mediated vasoconstriction.
What to do
Monitor blood pressure and heart rate when epinephrine is given to patients on metoprolol. In refractory anaphylaxis in a beta-blocked patient, consider glucagon.
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 Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Epinephrine with Metoprolol?
MediHelp rates the interaction as moderate. Epinephrine 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. Beta-blockade blunts the cardiac and bronchodilator effects of epinephrine, reducing its benefit in anaphylaxis. With a cardioselective agent such as metoprolol, unopposed alpha-adrenergic stimulation may still cause hypertension with reflex bradycardia, particularly at higher doses.
How serious is the interaction between Epinephrine 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: Monitor blood pressure and heart rate when epinephrine is given to patients on metoprolol. In refractory anaphylaxis in a beta-blocked patient, consider glucagon.
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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