Drug interactions
Metoprolol + Ritonavir
Severity: Moderate
Metoprolol and Ritonavir: 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
Ritonavir inhibits CYP2D6 and can raise metoprolol exposure, leading to bradycardia, hypotension and fatigue. The risk is higher in poor CYP2D6 metabolizers or at higher metoprolol doses.
What this interaction means in plain words
Metoprolol and Ritonavir 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 belongs to Cardiovascular; Ritonavir belongs to Anti Virals.
Why it happens
Inhibition of CYP2D6-mediated metoprolol metabolism by ritonavir.
What to do
Monitor heart rate and blood pressure and consider a lower metoprolol dose. Consider a beta-blocker not dependent on CYP2D6 if the effect is excessive.
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
Other interactions of Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Metoprolol with Ritonavir?
MediHelp rates the interaction as moderate. Metoprolol and Ritonavir 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. Ritonavir inhibits CYP2D6 and can raise metoprolol exposure, leading to bradycardia, hypotension and fatigue. The risk is higher in poor CYP2D6 metabolizers or at higher metoprolol doses.
How serious is the interaction between Metoprolol and Ritonavir?
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 consider a lower metoprolol dose. Consider a beta-blocker not dependent on CYP2D6 if the effect is excessive.
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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