Drug interactions
Metoprolol + Pindolol
Severity: Major
Metoprolol and Pindolol: 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
Two beta-blockers given together add to each other's effects on heart rate, AV conduction and blood pressure, with no real gain in benefit. The risk of marked bradycardia, heart block, hypotension and worsening heart failure rises. Pindolol's intrinsic sympathomimetic activity may also partly blunt the effect of metoprolol.
What this interaction means in plain words
Metoprolol and Pindolol 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.
Why it happens
Additive pharmacodynamic beta-adrenergic blockade at the heart and vasculature.
What to do
Avoid combining two systemic beta-blockers and keep a single agent at an optimized dose. If the combination is unavoidable, monitor heart rate, blood pressure and ECG closely.
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
Frequently asked questions
Can I take Metoprolol with Pindolol?
MediHelp rates the interaction as major. Metoprolol and Pindolol 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. Two beta-blockers given together add to each other's effects on heart rate, AV conduction and blood pressure, with no real gain in benefit. The risk of marked bradycardia, heart block, hypotension and worsening heart failure rises. Pindolol's intrinsic sympathomimetic activity may also partly blunt the effect of metoprolol.
How serious is the interaction between Metoprolol and Pindolol?
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 combining two systemic beta-blockers and keep a single agent at an optimized dose. If the combination is unavoidable, monitor heart rate, blood pressure and ECG closely.
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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