Drug interactions
Metoprolol + Salmeterol
Severity: Moderate
Metoprolol and Salmeterol: 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
Beta-blockers oppose the bronchodilator action of salmeterol and may provoke bronchospasm in patients with asthma or COPD. Metoprolol is relatively beta-1 selective, so the risk is lower than with nonselective agents but is still present at higher doses.
What this interaction means in plain words
Metoprolol and Salmeterol 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; Salmeterol belongs to Respiratory.
Why it happens
Pharmacodynamic antagonism at beta-adrenergic receptors, with loss of selectivity at higher metoprolol doses.
What to do
Use the lowest effective dose of metoprolol and monitor respiratory symptoms and lung function in patients with reactive airway disease. Avoid in asthma if an alternative is available.
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 Salmeterol
- Ritonavir + Salmeterol Contraindicated
- Salmeterol + Saquinavir Contraindicated
- Amitriptyline + Salmeterol Major
- Arformoterol + Salmeterol Major
- Atazanavir + Salmeterol Major
- Budesonide-formoterol + Salmeterol Major
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 Salmeterol?
MediHelp rates the interaction as moderate. Metoprolol and Salmeterol 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. Beta-blockers oppose the bronchodilator action of salmeterol and may provoke bronchospasm in patients with asthma or COPD. Metoprolol is relatively beta-1 selective, so the risk is lower than with nonselective agents but is still present at higher doses.
How serious is the interaction between Metoprolol and Salmeterol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective dose of metoprolol and monitor respiratory symptoms and lung function in patients with reactive airway disease. Avoid in asthma if an alternative is available.
What other medicines interact with Salmeterol?
MediHelp also lists interactions of Salmeterol with, for example, Ritonavir, Saquinavir, Amitriptyline. The full list is on the Salmeterol page.
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