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5 Interactions found for:

metoprolol and Vitamin B12
Interactions Summary
  • 2 Major
  • 1 Moderate
  • 2 Minor
  • metoprolol
  • Vitamin B12

Drug Interactions

No drug interactions were found for selected drugs: metoprolol, Vitamin B12.

This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Drug and Food Interactions

Moderate
Metoprolol + Food

The following applies to the ingredients: 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.

References

  1. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
  2. Darcy PF "Nutrient-drug interactions." Adverse Drug React Toxicol Rev 14 (1995): 233-54

The following applies to the ingredients: Metoprolol

ADJUST DOSING INTERVAL: Concurrent administration with calcium salts may decrease the oral bioavailability of atenolol and possibly other beta-blockers. The exact mechanism of interaction is unknown. In six healthy subjects, calcium 500 mg (as lactate, carbonate, and gluconate) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of atenolol (100 mg) by 51% and 32%, respectively. The elimination half-life increased by 44%. Twelve hours after the combination, beta-blocking activity (as indicated by inhibition of exercise tachycardia) was reduced compared to that with atenolol alone. However, during a 4-week treatment in six hypertensive patients, there was no difference in blood pressure values between treatments. The investigators suggest that prolongation of the elimination half-life induced by calcium coadministration may have led to atenolol cumulation during long-term dosing, which compensated for the reduced bioavailability.

MANAGEMENT: It may help to separate the administration times of beta-blockers and calcium products by at least 2 hours. Patients should be monitored for potentially diminished beta-blocking effects following the addition of calcium therapy.

References

  1. Kirch W, Schafer-Korting M, Axthelm T, Kohler H, Mutschler E "Interaction of atenolol with furosemide and calcium and aluminum salts." Clin Pharmacol Ther 30 (1981): 429-35

Drug and Pregnancy Interactions

The following applies to the ingredients: Metoprolol

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

The following applies to the ingredients: Cyanocobalamin (found in Vitamin B12)

This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. (AU)

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

Comments:
-Vitamin B12 needs are increased in pregnancy.
-Megaloblastic anemia of pregnancy is usually due to folic acid deficiency.
-Do not use for megaloblastic anemia of pregnancy due to folic acid deficiency.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. Allen LH "Multiple micronutrients in pregnancy and lactation: an overview." Am J Clin Nutr 81(S) (2005): 1206S-12S
  4. "Product Information. Cyanocobalamin (cyanocobalamin)." West Ward Pharmaceutical Corporation (2017):

Drug and Breastfeeding Interactions

The following applies to the ingredients: Metoprolol

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: Cyanocobalamin (found in Vitamin B12)

Use is not recommended; benefit to mother should outweigh risk to the infant. (AU)

Excreted into human milk: Yes

Comments:
-Vitamin B12 needs are increased in lactation.
-Deficiency has been seen in breast fed children of vegetarian mothers, even with no symptoms of maternal deficiency.
-Four micrograms daily of B12 are recommended during lactation.

References

  1. Ehrlich A, Koch T, Amin B, et al. "Development and reliability testing of a standardized questionnaire to assess psoriasis phenotype." J Am Acad Dermatol 54 (2006): 987.e1-14
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Nascobal (cyanocobalamin)." Par Pharmaceutical Inc (2017):

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: Consumer 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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