Drug interactions
Metoprolol + Nadolol
Severity: Major
Metoprolol and Nadolol: major interaction.
Last updated Sources: US FDA label
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 beta-blockers, so combining them is therapeutic duplication without a meaningful gain in benefit. It increases the risk of bradycardia, hypotension, AV block and fatigue.
What this interaction means in plain words
Metoprolol and Nadolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Metoprolol belongs to Cardiovascular; Nadolol belongs to Cardiovascular.
Why it happens
Duplicate beta-adrenergic receptor blockade producing additive negative chronotropic, inotropic and hypotensive effects.
What to do
Avoid using two systemic beta-blockers together and keep a single agent at an optimized dose. If a switch is needed, stop one before starting the other and monitor heart rate and blood pressure.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Nadolol
Frequently asked questions
Can I take Metoprolol with Nadolol?
MediHelp rates the interaction as major. Metoprolol and Nadolol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are beta-blockers, so combining them is therapeutic duplication without a meaningful gain in benefit. It increases the risk of bradycardia, hypotension, AV block and fatigue.
How serious is the interaction between Metoprolol and Nadolol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using two systemic beta-blockers together and keep a single agent at an optimized dose. If a switch is needed, stop one before starting the other and monitor heart rate and blood pressure.
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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