metoprolol
5 interactions related to metoprolol
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.
metoprolol + melatonin
Metoprolol blocks the beta-1 adrenergic receptors that drive pineal melatonin synthesis, suppressing endogenous nighttime melatonin and contributing to insomnia, vivid dreams, and reduced sleep efficiency. Low-dose oral melatonin can restore sleep without interfering with metoprolol's cardiovascular benefits.
cbd + beta-blockers
CBD inhibits several CYP450 enzymes (notably CYP3A4, CYP2C19, CYP2C9, CYP1A2) and may modestly inhibit CYP2D6. Beta-blockers such as metoprolol, propranolol, and carvedilol are metabolized via CYP2D6 (and CYP1A2 for propranolol), so co-use can raise beta-blocker plasma levels, with additive blood-pressure lowering and bradycardia.
energy drinks + beta-blockers
Energy drinks raise sympathetic tone through caffeine, taurine, and guarana, opposing the heart-rate and blood-pressure lowering effects of beta-blockers like metoprolol, atenolol, propranolol, and bisoprolol. Case reports document refractory arrhythmias and hypertensive episodes in patients on beta-blocker therapy who consumed energy drinks regularly.