Drug interactions
Ipratropium-salbutamol + Metoprolol
Severity: Moderate
Ipratropium-salbutamol 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
Metoprolol can blunt the bronchodilator effect of salbutamol and, at higher doses, lose its cardioselectivity and provoke bronchospasm in patients with asthma or COPD. This may reduce rescue inhaler effectiveness during an exacerbation.
What this interaction means in plain words
Ipratropium-salbutamol 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.
Ipratropium-salbutamol belongs to Respiratory; Metoprolol belongs to Cardiovascular.
Why it happens
Pharmacodynamic antagonism: metoprolol blocks beta-1 receptors and, to a lesser degree, beta-2 receptors that salbutamol stimulates.
What to do
Keep the metoprolol dose as low as possible in patients with reactive airway disease and monitor respiratory status and response to salbutamol. Consider a non-beta-blocker alternative if asthma is poorly controlled.
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 Ipratropium-salbutamol
Other interactions of Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol Major
Frequently asked questions
Can I take Ipratropium-salbutamol with Metoprolol?
MediHelp rates the interaction as moderate. Ipratropium-salbutamol 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. Metoprolol can blunt the bronchodilator effect of salbutamol and, at higher doses, lose its cardioselectivity and provoke bronchospasm in patients with asthma or COPD. This may reduce rescue inhaler effectiveness during an exacerbation.
How serious is the interaction between Ipratropium-salbutamol 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: Keep the metoprolol dose as low as possible in patients with reactive airway disease and monitor respiratory status and response to salbutamol. Consider a non-beta-blocker alternative if asthma is poorly controlled.
What other medicines interact with Ipratropium-salbutamol?
MediHelp also lists interactions of Ipratropium-salbutamol with, for example, Amisulpride, Arsenic trioxide, Carvedilol. The full list is on the Ipratropium-salbutamol page.
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