Metoprolol Tartrate And Hydrochlorothiazide Interactions

7.2 Drug Interactions with Hydrochlorothiazide Antidiabetic Drugs (oral agents and insulin) Dosage adjustment of the antidiabetic drug may be required. Ion Exchange Resins Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85% and 43%, respectively.

Source: FDA drug label - metoprolol tartrate and hydrochlorothiazide

( 7.1 ) • CYP2D6 inhibitors: Increased metoprolol concentration. ( 7.2 ) 7.1 Drug Interactions with Metoprolol Catecholamine Depleting Drugs The concomitant use of catecholamine-depleting drugs (e.g., reserpine, monoamine oxidase (MAO) inhibitors) with beta adrenergic blockers may have an additive affect and increase the risk of hypotension or bradycardia. CYP2D6 Inhibitors Drugs that are strong inhibitors of CYP2D6 such as quinidine, fluoxetine, paroxetine, and propafenone were shown to double metoprolol concentrations.

Source: FDA drug label - metoprolol tartrate and hydrochlorothiazide

Known clinically significant potent inhibitors of CYP2D6 are antidepressants such as fluoxetine, paroxetine or bupropion, antipsychotics such as thioridazine, antiarrhythmics such as quinidine or propafenone, antiretrovirals such as ritonavir, antihistamines such as diphenhydramine, antimalarials such as hydroxychloroquine or quinidine, antifungals such as terbinafine and medications for stomach ulcers such as cimetidine.

Source: FDA drug label - metoprolol tartrate and hydrochlorothiazide