Drug interactions
Metoprolol + Rifampin
Severity: Moderate
Metoprolol and Rifampin: 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
Rifampin induces hepatic metabolism and lowers metoprolol plasma levels, which can reduce its heart rate and blood pressure effects. The effect persists for some time after rifampin is stopped.
What this interaction means in plain words
Metoprolol and Rifampin 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.
Why it happens
Induction of hepatic CYP enzymes by rifampin increases metoprolol clearance.
What to do
Monitor heart rate and blood pressure and increase the metoprolol dose as needed. Reduce it again after rifampin is discontinued.
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
Frequently asked questions
Can I take Metoprolol with Rifampin?
MediHelp rates the interaction as moderate. Metoprolol and Rifampin 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. Rifampin induces hepatic metabolism and lowers metoprolol plasma levels, which can reduce its heart rate and blood pressure effects. The effect persists for some time after rifampin is stopped.
How serious is the interaction between Metoprolol and Rifampin?
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 and increase the metoprolol dose as needed. Reduce it again after rifampin is discontinued.
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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