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8 Interactions found for:

amlodipine and Metoprolol Succinate ER
Interactions Summary
  • 4 Major
  • 3 Moderate
  • 1 Minor
  • amlodipine
  • Metoprolol Succinate ER

Drug Interactions

Moderate
Metoprolol Succinate Er + Amlodipine

The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er) and Amlodipine

Metoprolol and amLODIPine may have additive effects in lowering your blood pressure and heart rate. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart beat. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Drug and Food Interactions

Moderate
Metoprolol Succinate Er + Food

The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)

Food can enhance the levels of metoprolol in your body. You should take metoprolol at the same time each day, preferably with or immediately following meals. This will make it easier for your body to absorb the medication. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking metoprolol. Metoprolol is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)

Using metoprolol together with multivitamin with minerals may decrease the effects of metoprolol. Separate the administration times of metoprolol and multivitamin with minerals by at least 2 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate
Amlodipine + Food

The following applies to the ingredients: Amlodipine

AmLODIPine and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

The following applies to the ingredients: Amlodipine

Using amLODIPine together with multivitamin with minerals can decrease the effects of amLODIPine. Talk with your doctor before using amLODIPine and multivitamin with minerals together. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Minor
Amlodipine + Food

The following applies to the ingredients: Amlodipine

Professional Content

The consumption of grapefruit juice may slightly increase plasma concentrations of amlodipine. The mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Data have been conflicting and the clinical significance is unknown. Monitoring for calcium channel blocker adverse effects (e.g., headache, hypotension, syncope, tachycardia, edema) is recommended.

References

  1. Bailey DG, Arnold JMO, Spence JD "Grapefruit juice and drugs - how significant is the interaction." Clin Pharmacokinet 26 (1994): 91-8
  2. Josefsson M, Zackrisson AL, Ahlner J "Effect of grapefruit juice on the pharmacokinetics of amlodipine in healthy volunteers." Eur J Clin Pharmacol 51 (1996): 189-93
  3. Bailey DG, Malcolm J, Arnold O, Spence JD "Grapefruit juice-drug interactions." Br J Clin Pharmacol 46 (1998): 101-10
  4. Vincent J, Harris SI, Foulds G, Dogolo LC, Willavize S, Friedman HL "Lack of effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of amlodipine." Br J Clin Pharmacol 50 (2000): 455-63
  5. Josefsson M, Ahlner J "Amlodipine and grapefruit juice." Br J Clin Pharmacol 53 (2002): 405; discussion 406
  6. Kane GC, Lipsky JJ "Drug-grapefruit juice interactions." Mayo Clin Proc 75 (2000): 933-42

Drug and Pregnancy Interactions

The following applies to the ingredients: Amlodipine

Professional Content

This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus (AU, US)
Use is contraindicated (UK)

AU TGA pregnancy category: C
US FDA pregnancy category: C

Comments:
-Use of adequate methods of contraception should be encouraged.
-If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus.

Animal studies have shown significantly decreased litter size, increased intrauterine deaths and prolongation of gestation and duration of labor when this drug was given before mating, throughout mating, and during gestation. There are no controlled data in human pregnancy.

Reversible biochemical changes in the head of spermatozoa occurred in some patients treated with calcium channel blockers. There are no controlled data for this drug, but animal models have shown adverse effects on male fertility.

AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

References

  1. "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals PROD (2002):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0

The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)

Professional Content

US: This drug should be used during pregnancy only if clearly needed.
AU and UK: Use is not recommended unless benefit outweighs risk; if used during pregnancy, administer the lowest possible dose and discontinue at least 2 to 3 days prior to expected delivery, if possible.

AU TGA pregnancy category: C
US FDA pregnancy category: C

Animal studies have revealed increased postimplantation loss, fetolethality, and decreased neonatal survival. There are no controlled data in human pregnancy.

AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

References

  1. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0

Drug and Breastfeeding Interactions

The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)

Professional Content

AU and UK: Use is not recommended unless benefit outweighs risk.
US: This drug has been used without apparent harmful effects; caution is recommended.

Excreted into human milk: Yes (in small amounts)

Comments: This drug has been used without apparent harmful effects in the nursing infant.

An infant consuming 1 L of breast milk a day would receive a dose of less than 1 mg of drug.

References

  1. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0

The following applies to the ingredients: Amlodipine

Professional Content

Use is not recommended and a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother (AU, US)
Use is contraindicated (UK)

Excreted into human milk: Yes

Comments:
-The effects in the nursing infant are unknown.
-Infants exposed to this drug should be closely monitored.

References

  1. "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals PROD (2002):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Switch to: Professional Interactions

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

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