7 Interactions found for:
Drug Interactions
No drug interactions were found for selected drugs: Metoprolol Succinate ER, simvastatin.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Drug and Food Interactions
Major
Simvastatin
+ Food
The following applies to the ingredients: Simvastatin
Grapefruit juice can significantly increase the blood levels of simvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You should avoid the consumption of grapefruit or grapefruit juice during treatment with simvastatin. Drinking green tea or taking green tea extracts may also increase the blood levels of simvastatin in some patients. Talk to your doctor or pharmacist if you have any questions or concerns. It may be advisable to avoid excessive consumption of green tea and green tea products while on simvastatin. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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
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
Simvastatin
+ Food
The following applies to the ingredients: Simvastatin
Simvastatin may cause liver problems and using it with substantial quantities of ethanol may increase that risk. You should limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. 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 Pregnancy Interactions
Major
Metoprolol Succinate Er
+ Pregnancy
The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)
Professional Content
Safety has not been established during pregnancy.
-According to some authorities: 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: Not assigned
Risk summary: Inconclusive data available on the use of this drug in pregnant women to inform a drug-related risk.
Comments:
-Based on published literature, this drug may cause erectile dysfunction and inhibit sperm motility.
Animal studies have revealed increased post-implantation loss, fetolethality, and decreased neonatal survival. This drug crosses placenta, neonates born to mothers who are receiving metoprolol during pregnancy, may be at risk for hypotension, hypoglycemia, bradycardia, and respiratory depression.
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 Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Kapspargo Sprinkle (metoprolol)." Sun Pharmaceutical Industries (2023):
- "Product Information. Toprol-XL (metoprolol)." Melinta Therapeutics, Inc. (2023):
- "Product Information. Lopressor (metoprolol)." Validus Pharmaceuticals LLC (2025):
- "Product Information. Metoprolol Tartrate (obsolete) (metoprolol)." Hikma USA (formerly West-Ward Pharmaceutical Corporation) (2025):
Major
Simvastatin
+ Pregnancy
The following applies to the ingredients: Simvastatin
Professional Content
Use is contraindicated.
AU TGA pregnancy category: D
US FDA pregnancy category:
-Oral suspension: X
-Oral tablet: Not assigned
Risk summary: Based on the mechanism of action, this drug may cause fetal harm when administered to a pregnant woman. Inadequate data available on the use of this drug in pregnant women to inform a drug-related risk.
Comments:
-This drug is contraindicated in women who are or who may become pregnant; women of childbearing potential should be advised to use effective contraception.
-If pregnancy occurs, this drug should be immediately discontinued.
Lipid lowering drugs offer no benefit during pregnancy. Cholesterol and cholesterol derivatives are needed for normal fetal development and HMG-CoA reductase inhibitors are known to inhibit these biosynthetic processes. Studies in rats and rabbits have not shown teratogenicity at doses about 3 times the human exposure, however, studies with a structurally-related statin found skeletal malformations in rats and mice. There are rare reports of congenital anomalies following intrauterine exposure. Two series of pregnant women who took an HMG-CoA reductase inhibitor (n=178 and n=134) during the first trimester of pregnancy, found serious fetal abnormalities in several cases including limb and neurological defects, spontaneous abortions, and fetal deaths. There are no controlled data in human pregnancy.
Atherosclerosis is a chronic process and the discontinuation of lipid-lowering drugs during pregnancy should have little impact on the outcome of long-term therapy of primary hypercholesterolemia.
AU TGA pregnancy category D: Drugs which have caused are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.
US FDA pregnancy category X: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- "Product Information. Zocor (simvastatin)." Merck & Co., Inc PROD (2001):
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Flolipid (simvastatin)." Salerno Pharmaceuticals LP (2020):
- "Product Information. Zocor (simvastatin)." Organon Pharmaceuticals (2023):
Drug and Breastfeeding Interactions
Major
Metoprolol Succinate Er
+ Breastfeeding
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
- "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
Major
Simvastatin
+ Breastfeeding
The following applies to the ingredients: Simvastatin
Professional Content
Use is contraindicated
Excreted into human milk: Unknown
Excreted into animal milk: Unknown
Comments: The effects in the nursing infant are unknown.
It is not known if this drug is excreted in human milk; a small amount of another statin drug has been observed in human milk. In animal studies, reduced weight gain was observed in rat offspring dosed with 12.5 to 25 mg/kg/day. Due to concerns with disrupting infant lipid metabolism, most experts agree that this drug should not be used during breastfeeding.
References
- "Product Information. Zocor (simvastatin)." Merck & Co., Inc PROD (2001):
- Cerner Multum, Inc. "Australian Product Information." O 0
- 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. |
Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a healthcare professional. Use of this content is subject to our terms of use & medical disclaimer.