Drug interactions
Esmolol + Metoprolol
Severity: Moderate
Esmolol 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
Both are beta1-selective blockers, so adding esmolol to a patient on metoprolol augments beta-blockade. This may cause profound bradycardia or hypotension, though esmolol's short duration limits the effect.
What this interaction means in plain words
Esmolol 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.
Esmolol belongs to Cardiovascular; Metoprolol belongs to Cardiovascular.
Why it happens
Additive beta1-adrenergic receptor blockade.
What to do
Use esmolol only with continuous heart rate and blood pressure monitoring and start at a low infusion rate. Reduce or stop the infusion if bradycardia or hypotension develops.
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 Esmolol
- Acebutolol + Esmolol Major
- Amifostine + Esmolol Major
- Amiodarone + Esmolol Major
- Celiprolol + Esmolol Major
- Diltiazem + Esmolol Major
- Epinephrine racemic + Esmolol Major
Frequently asked questions
Can I take Esmolol with Metoprolol?
MediHelp rates the interaction as moderate. Esmolol 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. Both are beta1-selective blockers, so adding esmolol to a patient on metoprolol augments beta-blockade. This may cause profound bradycardia or hypotension, though esmolol's short duration limits the effect.
How serious is the interaction between Esmolol 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: Use esmolol only with continuous heart rate and blood pressure monitoring and start at a low infusion rate. Reduce or stop the infusion if bradycardia or hypotension 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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