Drug interactions
Metoprolol + Sotalol
Severity: Major
Metoprolol and Sotalol: 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
Sotalol is a non-selective beta-blocker with class III antiarrhythmic activity, so adding metoprolol duplicates beta-blockade. This raises the risk of severe bradycardia, hypotension and AV block, and the extra beta-blockade gives no antiarrhythmic gain.
What this interaction means in plain words
Metoprolol and Sotalol 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.
Metoprolol belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Duplicate beta-adrenergic blockade with additive negative chronotropic, dromotropic and hypotensive effects.
What to do
Avoid the combination and use a single beta-blocker, choosing sotalol only when its antiarrhythmic action is needed. Monitor heart rate, blood pressure and ECG if a transition is made.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Metoprolol and Sotalol, 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.
References
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Metoprolol with Sotalol?
MediHelp rates the interaction as major. Metoprolol and Sotalol 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. Sotalol is a non-selective beta-blocker with class III antiarrhythmic activity, so adding metoprolol duplicates beta-blockade. This raises the risk of severe bradycardia, hypotension and AV block, and the extra beta-blockade gives no antiarrhythmic gain.
How serious is the interaction between Metoprolol and Sotalol?
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 the combination and use a single beta-blocker, choosing sotalol only when its antiarrhythmic action is needed. Monitor heart rate, blood pressure and ECG if a transition is made.
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.
