What To Avoid When Taking Metoprolol (& Beta Blockers) | Substances & Medication Interactions

JJ Medicine
13 Jun 202307:29
EducationalLearning
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TLDRThe video script discusses metoprolol, a beta-blocker medication used for treating hypertension, angina, heart failure, myocardial infarctions, and arrhythmias. It explains how metoprolol works by blocking beta-1 receptors, reducing heart rate and blood pressure. The video highlights the importance of avoiding certain substances and medications when taking metoprolol to prevent severe side effects. These include alcohol, marijuana, SSRI antidepressants, other beta-blockers, NSAIDs, diphenhydramine, heart medications like digoxin and quinidine, and Verapamil. The script emphasizes understanding how metoprolol is metabolized by the liver enzyme CYP2D6 and the potential interactions with other medications that affect this enzyme.

Takeaways
  • 💡 Metoprolol, also known as Lopressor, is a medication used to treat high blood pressure, angina, heart failure, myocardial infarctions, and arrhythmias like atrial fibrillation.
  • 🚫 Metoprolol is a beta-blocker that primarily targets beta1 receptors in the heart, reducing blood pressure and heart rate by blocking the effects of catecholamines like epinephrine and norepinephrine.
  • 🧬 The drug is metabolized in the liver by an enzyme called CYP2D6, which breaks it down into metabolites and has a half-life of three to four hours.
  • 🍷 Alcohol should be avoided or reduced when taking metoprolol as both substances can lower blood pressure, increasing the risk of hypotension or dizziness.
  • 🌿 Marijuana or cannabis use can increase metoprolol levels due to changes in CYP2D6 metabolism, potentially leading to higher side effects.
  • 💊 SSRI antidepressants like Prozac, Paxil, and Zoloft can interact with metoprolol, enhancing its effects and potentially causing lower blood pressure and heart rate.
  • 🔄 Concurrent use of other beta blockers with metoprolol should be avoided to prevent additive effects on heart rate and blood pressure, worsening side effects.
  • 💦 NSAIDs like ibuprofen and naproxen can increase potassium levels in the blood when used with metoprolol, which can lead to significant hyperkalemia.
  • 💓 Antiarrhythmic medications such as digoxin and quinidine can interact with metoprolol, potentially increasing side effects and affecting heart rate and blood pressure regulation.
  • 📈 Metoprolol can interact with a variety of other medications, including diphenhydramine (Benadryl), clonidine, cimetidine, furosemide, amiodarone, chlorpromazine, and many others, often leading to mild interactions.
Q & A

  • What is metoprolol also known as?

    -Metoprolol is also known as Lopressor.

  • What is the primary use of metoprolol?

    -Metoprolol is primarily used to reduce blood pressure and heart rate, and it is utilized in the treatment of hypertension, anginal chest pain, congestive heart failure, acute myocardial infarctions, and arrhythmias like atrial fibrillation.

  • How does metoprolol work to reduce blood pressure?

    -Metoprolol works by blocking beta adrenergic receptors, more specifically beta1 receptors in the heart. This action prevents catecholamines like epinephrine and norepinephrine from binding to the beta-1 receptors, which in turn helps to reduce the heart rate and renin release, leading to a reduction in blood pressure.

  • What are some side effects of metoprolol?

    -Some side effects of metoprolol can include bradycardia (too low heart rate), hypotension (low blood pressure), dizziness, and headaches.

  • How is metoprolol metabolized in the body?

    -Metoprolol is metabolized in the liver by an enzyme called CYP2D6, which breaks down metoprolol into its metabolites. It has a half-life of three to four hours.

  • Why should alcohol be avoided when taking metoprolol?

    -Alcohol should be avoided when taking metoprolol because both substances can reduce blood pressure. Combining them may lead to excessive reductions in blood pressure, resulting in hypotension or dizziness.

  • How does marijuana or cannabis interact with metoprolol?

    -Marijuana or cannabis can increase levels of metoprolol in the body due to changes it induces in CYP2D6 metabolism. This can lead to higher levels of metoprolol, potentially worsening side effects.

  • What is the potential interaction between metoprolol and SSRI antidepressants?

    -SSRI antidepressants can interact with metoprolol because they affect CYP2D6 metabolism, which can lead to increased levels of metoprolol and potentially stronger effects, including lower blood pressure and heart rate, as well as other side effects.

  • Why should other beta blockers be avoided when taking metoprolol?

    -Other beta blockers should be avoided when taking metoprolol because they can have an additive effect, leading to a greater reduction in heart rate and blood pressure, which can exacerbate side effects.

  • How can NSAIDs interact with metoprolol?

    -NSAIDs can interact with metoprolol by increasing potassium levels in the blood. Since metoprolol can already lead to mild increases in potassium, using NSAIDs can further elevate potassium levels, potentially leading to significant increases.

  • What are some other heart medications that can interact with metoprolol?

    -Other heart medications that can interact with metoprolol include antiarrhythmia medications like disopyramide, quinidine, and digoxin, as well as calcium channel blockers like verapamil. These interactions can lead to increased side effects or exacerbate conditions like bradycardia or excessive reduction in blood pressure.

Outlines
00:00
💡 Understanding Metoprolol and Its Interactions

This paragraph introduces metoprolol, a medication also known as Lopressor, used to treat conditions like hypertension, angina, heart failure, and arrhythmias by blocking beta-1 receptors in the heart. It explains how metoprolol reduces blood pressure and heart rate, its side effects, and its metabolism by the liver enzyme CYP2D6. The importance of understanding these aspects is emphasized to recognize potential interactions that can increase side effects.

05:02
🚫 Substances and Medications to Avoid with Metoprolol

The second paragraph discusses various substances and medications that should be avoided or used cautiously with metoprolol due to potential interactions. It highlights alcohol, which can exacerbate the blood pressure-lowering effects of metoprolol, leading to hypotension. It also mentions marijuana, which can increase metoprolol levels due to changes in CYP2D6 metabolism. The paragraph further covers SSRI antidepressants, other beta blockers, and NSAIDs, all of which can interact with metoprolol and increase side effects. Additionally, it touches on antiarrhythmic medications, digoxin, and calcium channel blockers like verapamil, which can also lead to increased side effects when taken with metoprolol.

Mindmap
Keywords
💡Metoprolol
Metoprolol, also known as Lopressor, is a medication used primarily to treat conditions such as high blood pressure (hypertension), angina (chest pain), heart failure, and certain types of irregular heartbeats (arrhythmias). It works by blocking beta-1 adrenergic receptors in the heart, which in turn reduces the heart rate and blood pressure. In the video, metoprolol is the central focus, and various interactions and side effects related to its use are discussed.
💡Beta Blockers
Beta blockers are a class of medications that work by blocking the action of certain stress hormones on the beta receptors of the heart and other organs in the body. They are primarily used to manage abnormal heart rhythms and heart disease, and to protect the heart from a second heart attack after a first heart attack has occurred. In the context of the video, metoprolol is a specific type of beta blocker that primarily targets beta-1 receptors in the heart.
💡Blood Pressure
Blood pressure is the force exerted by the blood against the walls of the blood vessels, and it is a vital sign that indicates the state of a person's cardiovascular health. High blood pressure, or hypertension, can lead to serious health problems if left untreated. Metoprolol is used to lower blood pressure by slowing the heart rate and reducing the force of the heart's contractions.
💡CYP2D6
CYP2D6 is an enzyme that is involved in the metabolism of many medications, including metoprolol. It is responsible for breaking down these drugs into metabolites, which can then be eliminated from the body. The activity of this enzyme can vary greatly among individuals, which can affect how people respond to certain medications. In the video, it is mentioned that metoprolol is metabolized by CYP2D6, and interactions with other substances can alter this process, potentially affecting the levels of metoprolol in the body.
💡Alcohol
Alcohol, specifically ethanol, is a substance that can have vasodilatory effects, meaning it can cause blood vessels to widen. This can lead to a decrease in blood pressure. When consumed in conjunction with metoprolol, which also lowers blood pressure, alcohol can exacerbate the hypotensive effects of the medication, potentially leading to symptoms such as dizziness and lightheadedness.
💡Marijuana
Marijuana, also known as cannabis, is a psychoactive drug derived from the Cannabis plant. It contains various compounds that can interact with the body's endocannabinoid system and affect many physiological processes. In the context of the video, marijuana use can alter the metabolism of metoprolol by affecting the CYP2D6 enzyme, potentially leading to increased levels of metoprolol in the body and a higher risk of side effects.
💡SSRI Antidepressants
SSRIs, or selective serotonin reuptake inhibitors, are a class of medications commonly used to treat depression and anxiety disorders. They work by increasing the levels of serotonin, a neurotransmitter, in the brain. However, certain SSRIs can also affect the metabolism of other medications like metoprolol by impacting the CYP2D6 enzyme, leading to increased levels of metoprolol and potentially more pronounced side effects.
💡NSAIDs
NSAIDs, or non-steroidal anti-inflammatory drugs, are a class of medications used to reduce inflammation and relieve pain. Common examples include ibuprofen, naproxen, and aspirin. While these drugs can be helpful, they can also interact with medications like metoprolol by increasing potassium levels in the blood, which can be problematic, especially for individuals with certain heart conditions.
💡Bradycardia
Bradycardia is a medical condition characterized by an abnormally slow heart rate, typically below 60 beats per minute for adults. This can lead to insufficient blood flow and can cause symptoms such as fatigue, dizziness, and shortness of breath. Medications like metoprolol, which are used to lower heart rate, can sometimes cause bradycardia as a side effect.
💡Digoxin
Digoxin is a medication used to treat heart failure and certain heart rhythm disorders, particularly atrial fibrillation. It works by increasing the strength of heart contractions and slowing the heart rate. However, digoxin can interact with metoprolol, potentially leading to increased levels of digoxin in the body, which can result in harmful side effects, including an excessive slowing of the heart rate.
💡Verapamil
Verapamil is a calcium channel blocker used to treat various heart conditions, including high blood pressure, angina, and certain types of arrhythmias. Like metoprolol, it works to slow the heart rate and reduce blood pressure. When taken together, these medications can increase the levels of each other in the body, leading to an enhanced effect and a higher risk of side effects.
💡Clonidine
Clonidine is an alpha-2 adrenergic agonist that is used to treat conditions such as high blood pressure, attention deficit hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). It works by stimulating specific receptors in the brain that help to lower blood pressure and reduce certain symptoms. When combined with metoprolol, the two medications can interact and increase the levels of each other, potentially leading to increased side effects.
Highlights

Metoprolol, also known as Lopressor, is a medication used to reduce blood pressure and heart rate. (Start Time: 0s)

It is primarily used to treat hypertension, anginal chest pain, congestive heart failure, acute myocardial infarctions, and arrhythmias like atrial fibrillation. (Start Time: 2s)

Metoprolol is a beta-blocker that works by blocking beta1 adrenergic receptors in the heart. (Start Time: 4s)

Blocking beta1 receptors prevents catecholamines like epinephrine and norepinephrine from binding, leading to reduced heart rate and renin release. (Start Time: 6s)

Metoprolol has a three to four hour half-life and is metabolized in the liver by an enzyme called CYP2D6. (Start Time: 8s)

Alcohol or ethanol should be reduced or avoided when taking metoprolol due to its vasodilative property, which can lead to hypotension or low blood pressure. (Start Time: 10s)

Marijuana or cannabis use can increase levels of metoprolol due to changes in CYP2D6 metabolism. (Start Time: 12s)

SSRI antidepressants like fluoxetine (Prozac), paroxetine (Paxil), and others can interact with metoprolol, potentially leading to higher levels and side effects. (Start Time: 14s)

Concurrent use of other beta blockers with metoprolol can exacerbate side effects due to their additive effect on reducing heart rate and blood pressure. (Start Time: 16s)

NSAIDs like ibuprofen and naproxen can increase potassium levels in the blood when used with metoprolol, potentially leading to significant increases. (Start Time: 18s)

Diphenhydramine (Benadryl), an antihistamine, can cause increased levels of metoprolol by inhibiting CYP2D6 metabolism. (Start Time: 20s)

Antiarrhythmia medications like deltaism and quinidine can interact with metoprolol and worsen bradycardia or lower heart rate. (Start Time: 22s)

Digoxin, another antiarrhythmic medication, can increase metoprolol levels and related side effects through an unknown mechanism. (Start Time: 24s)

Verapamil, a calcium channel blocker, can interact with metoprolol, leading to increased levels of both and potentially more side effects. (Start Time: 26s)

Metoprolol can interact with clonidine, an alpha-2 adrenergic agonist, leading to increased levels of each and more side effects. (Start Time: 28s)

Metoprolol can also interact with a variety of other medications, including cimetidine, furosemide, amiodarone, chlorpromazine, ritonavir, and many others. (Start Time: 30s)

For more information on metoprolol side effects, there are dedicated lessons available for reference. (Start Time: 32s)

Transcripts

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MetoprololHypertensionHeart MedicationAlcohol InteractionCannabis EffectSSRIsBeta-BlockersMedication SafetyHealth AdvicePharmacology