Diphenoxylate and atropine and Lopressor (Metoprolol Injection)
Determining the interaction of Diphenoxylate and atropine and Lopressor (Metoprolol Injection) and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Using atropine together with metoprolol may alter the effects of both medications. Contact your doctor if you experience drowsiness, dizziness, lightheadedness, confusion, blurred vision, dry mouth, or difficulty urinating. You may need a dose adjustment or need your blood pressure checked more often to safely use both medications. You should avoid activities requiring mental alertness until you know how the medications will affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Professional:MONITOR: Anticholinergic agents frequently cause drowsiness and other central nervous system-depressant effects that may be additive with those induced by beta blockers. In addition, these agents may increase heart rate and theoretically may counteract the bradycardic effects of beta blockers. Pharmacokinetically, anticholinergic agents may delay the gastrointestinal absorption of beta blockers and other drugs that are administered orally. The proposed mechanism involves increased gastrointestinal transit time due to reduction of stomach and intestinal motility by anticholinergic agents. In healthy volunteers, pretreatment with propantheline has been shown to prolong the time to reach peak plasma concentration (Tmax) for both atenolol and metoprolol. Propantheline also decreased metoprolol peak plasma concentration (Cmax) but had no effect on its systemic exposure (AUC). In contrast, propantheline increased atenolol AUC but had no effect on its Cmax. The clinical relevance of these changes is probably minimal.
MANAGEMENT: Patients should be monitored for potentially excessive CNS adverse effects (e.g., drowsiness, dizziness, lightheadedness, confusion, blurred vision) if anticholinergic agents are used in combination with beta blockers. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.
- Briant RH, Dorrington RE, Ferry DG, Paxton JW "Bioavailability of metoprolol in young adults and the elderly, with additional studies on the effects of metoclopramide and probanthine." Eur J Clin Pharmacol 25 (1983): 353-6
- Clark JM, Seager SJ "Gastric emptying following premedication with glycopyrrolate or atropine." Br J Anaesth 55 (1983): 1195-9
- Gilman AG, Rall TW, Nies AS, Taylor P, eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 8th ed." New York, NY: Pergamon Press Inc. (1990):
- Regardh CG, Lundborg P, Persson BA "The effect of antacid, metoclopramide, and propantheline on the bioavailability of metoprolol and atenolol." Biopharm Drug Dispos 2 (1981): 79-87
Generic Name: atropine / diphenoxylate
Brand name: Lomotil, Lonox, Lomocot, Vi-Atro
Synonyms: Atropine and diphenoxylate, Diphenoxylate and Atropine
Generic Name: metoprolol
Brand name: Lopressor, Kapspargo Sprinkle, Toprol-XL, Toprol XL
Synonyms: Lopressor (Injection), Lopressor
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
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