Drug interactions
Guanfacine + Metoprolol
Severity: Moderate
Guanfacine 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 drugs lower heart rate and blood pressure, so combined use can cause additive hypotension and bradycardia. If guanfacine is withdrawn abruptly during beta-blocker therapy, rebound hypertension may be exaggerated.
What this interaction means in plain words
Guanfacine 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.
Guanfacine belongs to Cardiovascular; Metoprolol belongs to Cardiovascular.
Why it happens
Additive sympatholytic effects from central alpha-2 agonism and beta-1 blockade, with unopposed alpha activity during clonidine-like withdrawal.
What to do
Monitor heart rate and blood pressure. When stopping both, withdraw the beta-blocker first, then taper guanfacine gradually.
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 Guanfacine
- Clonidine + Guanfacine Major
- Guanfacine + Lofexidine Major
- Aldesleukin + Guanfacine Moderate
- Amiodarone + Guanfacine Moderate
- Amisulpride + Guanfacine Moderate
- Amitriptyline + Guanfacine Moderate
Frequently asked questions
Can I take Guanfacine with Metoprolol?
MediHelp rates the interaction as moderate. Guanfacine 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 drugs lower heart rate and blood pressure, so combined use can cause additive hypotension and bradycardia. If guanfacine is withdrawn abruptly during beta-blocker therapy, rebound hypertension may be exaggerated.
How serious is the interaction between Guanfacine 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 heart rate and blood pressure. When stopping both, withdraw the beta-blocker first, then taper guanfacine gradually.
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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