Metoprolol with Dobutamine Interaction Details
Brand Names Associated with Metoprolol
- Dutoprol® (as a combination product containing Metoprolol, Hydrochlorothiazide)
- Kapspargo Sprinkle®
- Lopressidone® (as a combination product containing Chlorthalidone, Metoprolol)
- Lopressor®
- Lopressor® HCT (as a combination product containing Metoprolol, Hydrochlorothiazide)
- Metoprolol
- Toprol®
- Toprol® XL
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 05, 2023
Interaction Effect
Decreased DOBUTamine efficacy
Interaction Summary
A clinical study demonstrated that carvedilol, to a lesser extent metoprolol, inhibited hemodynamic response to DOBUTamine when given concurrently. Hemodynamic parameters should be carefully monitored when DOBUTamine is given with metoprolol.
Severity
Minor
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Use caution if metoprolol and DOBUTamine are coadministered because metoprolol antagonizes the activity of DOBUTamine and can decrease the effectiveness of DOBUTamine therapy. If DOBUTamine therapy is necessary in a patient on metoprolol, consider additional monitoring of blood pressure and heart rate.
Mechanism Of Interaction
Antagonism of DOBUTamine effects by beta adrenergic blockade
Literature Reports
A) In a crossover study (n=34) of patients with chronic heart failure (HF), carvedilol and, to a lesser extent, metoprolol inhibited hemodynamic response to DOBUTamine. Patients with a New York Heart Association functional class of II to IV, a left ventricular ejection fraction (LVEF) of less than 35%, and who were currently on furosemide and an ACE inhibitor were included. During the first part, DOBUTamine was infused in increasing doses (5, 10, 15, and 20 mcg/kg/min) and hemodynamic variables were calculated. The second hemodynamic study occurred 9 to 12 months later, after the patients had continuously been on either metoprolol (n=15) or carvedilol (n=14). Metoprolol demonstrated a slight, but not significant, increase in mean arterial pressure (MAP) at DOBUTamine infusion rates of 15 and 20 mcg/kg/min. Systemic vascular resistance (SVR) declined in a dose-dependent manner in response. Conversely, in patients taking carvedilol, DOBUTamine infusions caused a dose-dependent increase in MAP and a similar increase in SVR, as opposed to the decline in SVR seen in the control. Pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) showed similar responses as MAP and SVR. After metoprolol therapy, DOBUTamine caused a similarly decreased but blunted PAP and PVR response, while treatment with DOBUTamine after carvedilol treatment caused a significant dose-dependent increase in PAP and PVR response. Overall, the study concluded that the response of hemodynamic factors (MAP, SVR, PAP, and PVR) to DOBUTamine therapy can be greatly influenced by the type of concomitant beta-blocker therapy .
Metoprolol Overview
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Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to treat chronic (long-term) angina (chest pain). Metoprolol is also used to improve survival after a heart attack. Metoprolol also is used in combination with other medications to treat heart failure. Metoprolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
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High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.