Drug interactions
Levodopa + Metolazone
Severity: Moderate
Levodopa and Metolazone: 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
Levodopa can cause orthostatic hypotension, and combined with a diuretic the blood pressure-lowering effect may be amplified. Patients may experience dizziness, falls or syncope, particularly when starting or increasing either drug.
What this interaction means in plain words
Levodopa and Metolazone 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.
Levodopa belongs to Central Nervous System; Metolazone belongs to Cardiovascular.
Why it happens
Additive hypotensive effects from levodopa-induced vasodilation and autonomic effects plus diuretic-induced volume depletion.
What to do
Measure orthostatic blood pressure when starting or adjusting therapy and counsel patients to rise slowly. Reduce the diuretic or antihypertensive dose if symptomatic hypotension occurs.
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 Metolazone
Other interactions of Levodopa
- Isocarboxazid + Levodopa Contraindicated
- Levodopa + Phenelzine Contraindicated
- Levodopa + Phenelzine (nonselective MAOI) Contraindicated
- Levodopa + Procarbazine Contraindicated
- Levodopa + Tranylcypromine Contraindicated
- Amisulpride + Levodopa Major
Frequently asked questions
Can I take Levodopa with Metolazone?
MediHelp rates the interaction as moderate. Levodopa and Metolazone 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. Levodopa can cause orthostatic hypotension, and combined with a diuretic the blood pressure-lowering effect may be amplified. Patients may experience dizziness, falls or syncope, particularly when starting or increasing either drug.
How serious is the interaction between Levodopa and Metolazone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure orthostatic blood pressure when starting or adjusting therapy and counsel patients to rise slowly. Reduce the diuretic or antihypertensive dose if symptomatic hypotension occurs.
What other medicines interact with Metolazone?
MediHelp also lists interactions of Metolazone with, for example, Amifostine, Amlodipine-hydrochlorothiazide-valsartan, Amlodipine-olmesartan-hydrochlorothiazide. The full list is on the Metolazone page.
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