Drug interactions
Metoprolol + Rivastigmine
Severity: Moderate
Metoprolol and Rivastigmine: 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
Rivastigmine increases cholinergic tone and can slow the heart rate, and metoprolol also reduces heart rate and AV conduction. Together they raise the risk of bradycardia, heart block and syncope, particularly in older patients.
What this interaction means in plain words
Metoprolol and Rivastigmine 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; Rivastigmine belongs to Central Nervous System.
Why it happens
Additive bradycardic effects from cholinesterase inhibition (vagotonic) and beta-adrenergic blockade.
What to do
Monitor heart rate and watch for dizziness, syncope or falls, especially at initiation and dose increases. Reduce the dose or change therapy if symptomatic bradycardia or conduction block develops.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Metoprolol and Rivastigmine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Rivastigmine
Frequently asked questions
Can I take Metoprolol with Rivastigmine?
MediHelp rates the interaction as moderate. Metoprolol and Rivastigmine 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. Rivastigmine increases cholinergic tone and can slow the heart rate, and metoprolol also reduces heart rate and AV conduction. Together they raise the risk of bradycardia, heart block and syncope, particularly in older patients.
How serious is the interaction between Metoprolol and Rivastigmine?
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 watch for dizziness, syncope or falls, especially at initiation and dose increases. Reduce the dose or change therapy if symptomatic bradycardia or conduction block develops.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
