I understand Metoprolol slows your heart rate down and 1 of the side effects can be depression. Can this be counter productive when using Zoloft? Thanks
Interactions between your selected drugs
metoprolol ↔ sertraline
Applies to: metoprolol, Zoloft (sertraline)
MONITOR: Limited clinical data suggest that selective serotonin reuptake inhibitors (SSRIs) may potentiate the pharmacologic effects of some beta-blockers. There have been case reports of patients stabilized on beta-blocker therapy who developed bradycardia, hypotension, and complete heart block following the addition of a SSRI, subsequently requiring discontinuation of one or both agents and/or institution of a permanent pacemaker. The interaction is also corroborated by data from in vitro and clinical studies involving paroxetine and metoprolol conducted by one group of investigators. The proposed mechanism is SSRI inhibition (competitive and/or noncompetitive) of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of beta-blockers such as carvedilol, labetalol, metoprolol, nebivolol, propranolol, and timolol.
Paroxetine and norfluoxetine (the active metabolite of fluoxetine), in particular, are potent inhibitors of CYP450 2D6 and may be more likely than other SSRIs to cause the interaction. On the other hand, fluvoxamine is a potent inhibitor of CYP450 1A2 and may significantly interact with propranolol, which is a substrate of both CYP450 2D6 and 1A2.
MANAGEMENT: During concomitant therapy with SSRIs, a lower initial dosage and more cautious titration of the beta-blocker may be appropriate. Cardiac function should be closely monitored and the beta-blocker dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of SSRI in patients who are stabilized on their beta-blocker regimen. Due to the long half-life of fluoxetine and its active metabolite, norfluoxetine, the risk of an interaction may exist for an extended period (up to several weeks) after discontinuation of fluoxetine. To avoid the interaction, use of beta-blockers that are primarily eliminated by the kidney such as atenolol, acebutolol, betaxolol, carteolol, and nadolol may be considered.
Other drugs that your selected drugs interact with
metoprolol interacts with more than 400 other drugs.
Zoloft (sertraline) interacts with more than 400 other drugs.
Interactions between your selected drugs and food
metoprolol ↔ food
Applies to: metoprolol
ADJUST DOSING INTERVAL: The bioavailability of metoprolol may be enhanced by food.
MANAGEMENT: Patients may be instructed to take metoprolol at the same time each day, preferably with or immediately following meals.
I have used both of those and didn't feel great taking either one. It really depends on the medication and how it works with your body. I took Metroprolol because my heart rate would go up to 300 beats per minute. It did help my heart but it made me very lethargic and that was because it was lowering my blood pressure when I already have hypotension. If your blood pressure isnt low you should feel fine. Zoloft never worked for me, but it did work for others. I was taking celexa with metroprolol which is just like zoloft and I was ok. suggest if you feel weird at all to talk to your doctor.
This is an old post but I had a question. I just got prescribed metoprolol succinate xl (25mg) and I take 100 mg of Zoloft. I see there is a moderate interaction between the two so when should I take them? One in the morning and one in the evening? It just worries me since there says there is a moderate reaction between them. Thanks
Hi, beatlefan! Because of the half lives of these drugs separating your doses wouldn't be all that helpful. Metoprolol stays in your system for about 24hrs and Zoloft even longer.
It's a benefit ~vs~ risk situation that your doctor should be aware of when prescribing these two medications, but if you should feel extreme dizziness, lightheadedness, fatigue, shortness of breath, chest pains, or tiring during physical activity let your doctor know as another beta-blocker may be more appropriate for you. This is most apt to occur when first starting these medications... if you've been taking them for awhile an interaction is more unlikely.
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