Drug interactions
Metoprolol + Tolfenamic acid
Severity: Moderate
Metoprolol and Tolfenamic acid: 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
NSAIDs such as tolfenamic acid can blunt the blood pressure lowering effect of beta-blockers like metoprolol, particularly with regular use over more than a week. Loss of blood pressure control may occur, and renal function can also be affected.
What this interaction means in plain words
Metoprolol and Tolfenamic acid 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; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandin synthesis causes sodium and fluid retention and opposes the antihypertensive effect of the beta-blocker.
What to do
Monitor blood pressure when an NSAID is used regularly with metoprolol and use the lowest effective NSAID dose for the shortest time. Consider paracetamol as an alternative analgesic.
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 Tolfenamic acid
Frequently asked questions
Can I take Metoprolol with Tolfenamic acid?
MediHelp rates the interaction as moderate. Metoprolol and Tolfenamic acid 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. NSAIDs such as tolfenamic acid can blunt the blood pressure lowering effect of beta-blockers like metoprolol, particularly with regular use over more than a week. Loss of blood pressure control may occur, and renal function can also be affected.
How serious is the interaction between Metoprolol and Tolfenamic acid?
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 blood pressure when an NSAID is used regularly with metoprolol and use the lowest effective NSAID dose for the shortest time. Consider paracetamol as an alternative analgesic.
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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