Metoprolol Alcohol

Drugs that affect all phosphodiesterase type 5 inhibitors include the following alcohol, amlodipine, angiotensin II receptor blockers, antacids, bendroflumethiazide, beta blockers, cimetidine, diuretics, enalaphl, metoprolol, nifedipine, rifampin, tacrolimus. 

Drugs that may affect benzodiazepines include alcohol, antacids, barbiturates, cimetidine, disulfiram, fluoxetine, isoniazid, ketoconazole, metoprolol, oral contraceptives, narcotics, probenecid, propoxyphene, propranolol, ranitidine, rifampin, scopolamine, theophylline, and valproic acid. 

Propranolol reduces the frequency and intensity of migraine headache. Other 13-receptor antagonists with preventive efficacy include metoprolol and probably also atenolol, timolol, and nadolol. The mechanism is not known. Since sympathetic activity may enhance skeletal muscle tremor, it is not surprising that 13 antagonists have been found to reduce certain tremors (see Chapter 28). The somatic manifestations of anxiety may respond dramatically to low doses of propranolol, particularly when taken prophylactically. For example, benefit has been found in musicians with performance anxiety ("stage fright"). Propranolol may contribute to the symptomatic treatment of alcohol withdrawal in some patients. 

Suicide by insulin has been reported in a 68-year-old, non-diabetic physician who had also taken metoprolol and alcohol. The blood metoprolol concentration was 0.4 microgram/ml (usual target range 0.035-0.5 micro-gram/ml) and alcohol 122 mg/dl (27 mmol/1). C-pep-tide could not be detected, serum insulin was 1849 iU/ml (normal fasting concentration below 16 pU/ml) (284). 

Steuer et al. demonstrated the use of supercritical fluid chromatography in the separation of enantiomers of 1,2 amino alcohols, namely pindolol, metoprolol, oxprenolol, propranolol, and DPT 201-106 using ionpairing modifiers [21]. The mobile phase consisted of carbon dioxide mixed with acetonitrile containing triethylamine as a counterion and /V-benzo-xycarbonylglycyl-L-proline as a chiral counterion. They found that the ca-... 

Clinically important, potentially hazardous interactions with alcohol, alprazolam, carbamazepine, metoprolol, phenelzine, ritonavir, warfarin... 

The haemodynamic and pharmacokinetic effects of atenolol and metoprolol in heaithy subjects do not appear to be changed by al-cohoi. There is some evidence that alcohol modestly reduces the haemodynamic effects of propranolol, and some of the effects of sotalol may also be changed by alcohol. Some evidence suggests that the effects of alcohol and atenolol/chlortalidone or propranolol are additive on the performance of some psychomotor tests, but the importance of this is uncertain. 

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