Metoprolol with Venlafaxine 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
Brand Names Associated with Venlafaxine
- Effexor®
- Effexor® XR
- Venlafaxine
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 12, 2023
Interaction Effect
Increased metoprolol plasma concentrations, but decreased metoprolol efficacy
Interaction Summary
Concomitant use of metoprolol and venlafaxine may increase the plasma concentration of metoprolol but may also reduce the efficacy of metoprolol. In healthy men (n=18), concomitant administration led to a 30% to 40% increase in metoprolol plasma concentrations, but the active alpha hydroxymetroprolol metabolite, venlafaxine, and O-desmethylvenlafaxine metabolite were unaltered. Control of preexisting hypertension before venlafaxine treatment and regular blood pressure monitoring during concurrent treatment are recommended.
Severity
Moderate
Onset
Unspecified
Evidence
Established
How To Manage Interaction
Concurrent administration of metoprolol and venlafaxine may increase plasma concentrations of metoprolol, but also may decrease the effectiveness of metoprolol blood pressure control. Control of preexisting hypertension before venlafaxine treatment and regular blood pressure monitoring during concomitant treatment are recommended.
Mechanism Of Interaction
Unknown
Literature Reports
A) Following concomitant administration of metoprolol (100 mg every 24 hours for 5 days) and venlafaxine (50 mg every 8 hours for 5 days) in 18 healthy men, metoprolol plasma concentrations increased by approximately 30% to 40%; however, the plasma concentrations of the active alpha hydroxymetroprolol metabolite were unaltered. Similarly, the pharmacokinetic parameters of venlafaxine and the O-desmethylvenlafaxine metabolite were also unaltered. Notably in this study, venlafaxine reduced the blood pressure lowering effect of metoprolol, but the clinical significance of reduction in metoprolol efficacy in hypertensive patients was not established .
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.
Venlafaxine Overview
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Venlafaxine is used to treat depression. Venlafaxine extended-release (long-acting) capsules are also used to treat generalized anxiety disorder (GAD; excessive worrying that is difficult to control), social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life), and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Venlafaxine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance.
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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.