Drug interactions
Metoprolol + Terbinafine
Severity: Moderate
Metoprolol and Terbinafine: 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
Metoprolol is cleared primarily by CYP2D6, so terbinafine can increase its exposure and effect. This may cause excessive bradycardia, hypotension and fatigue.
What this interaction means in plain words
Metoprolol and Terbinafine 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; Terbinafine belongs to Anti Fungals.
Why it happens
Terbinafine inhibits CYP2D6, reducing the first-pass and systemic metabolism of metoprolol.
What to do
Monitor heart rate and blood pressure when starting or stopping terbinafine. Reduce the metoprolol dose if bradycardia or hypotension 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?
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Other interactions of Terbinafine
- Terbinafine + Thioridazine Contraindicated
- Desipramine + Terbinafine Major
- Eliglustat + Terbinafine Major
- Flecainide + Terbinafine Major
- Imipramine + Terbinafine Major
- Maprotiline + Terbinafine 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 Terbinafine?
MediHelp rates the interaction as moderate. Metoprolol and Terbinafine 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 is cleared primarily by CYP2D6, so terbinafine can increase its exposure and effect. This may cause excessive bradycardia, hypotension and fatigue.
How serious is the interaction between Metoprolol and Terbinafine?
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 when starting or stopping terbinafine. Reduce the metoprolol dose if bradycardia or hypotension develops.
What other medicines interact with Terbinafine?
MediHelp also lists interactions of Terbinafine with, for example, Thioridazine, Desipramine, Eliglustat. The full list is on the Terbinafine page.
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