heart-failure
4 interactions related to heart-failure
metoprolol + coq10
Beta-blockers like metoprolol inhibit CoQ10-dependent mitochondrial enzymes, gradually depleting CoQ10 levels in heart tissue and potentially contributing to fatigue, exercise intolerance, and reduced cardiac energy production. CoQ10 supplementation does not reduce metoprolol's blood pressure or heart rate effects but may offset these mitochondrial side effects.
metoprolol + hawthorn
Hawthorn (Crataegus) has mild vasodilatory and positive inotropic effects that can additively lower blood pressure and slow heart rate when combined with metoprolol, increasing the risk of hypotension, bradycardia, dizziness, or syncope. The interaction is pharmacodynamic, not metabolic, so spacing the doses does not prevent it.
carvedilol + st. john's wort
Carvedilol is metabolized by CYP2D6, CYP2C9, CYP3A4, and CYP1A2, and is also a P-glycoprotein substrate. St. John's Wort potently induces several of these enzymes and P-gp, accelerating carvedilol clearance and reducing plasma levels, which can blunt its heart failure and antihypertensive effects.
hawthorn + coq10
Hawthorn (Crataegus) flavonoids improve myocardial contractility and coronary blood flow through mild ACE inhibition and vasodilation, while CoQ10 supports cardiac ATP production in the electron transport chain. Together they address both the mechanical and metabolic demands of the failing or stressed heart.