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Medication interaction: Metoprolol and Myrbetriq

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  • Medication interaction: Metoprolol and Myrbetriq

    I am supposed to start taking Myrbetriq for my bladder spasticity so I was reading up about it, and I came across this information regarding a reaction with metoprolol. I am currently taking 25 mg of metoprolol in the morning and at bedtime. The urologist that prescribed the Myrbetriq did not really look well at my chart so I do not think that he realized that I was also taking metoprolol.

    Is there anything in particular that I would need to look out for when taking both of these medications at the same time? I am trying to decide if this possible interaction is worth the benefits I might get from switching to Myrbetriq.

    I just found better information regarding the interaction and it doesn't sound very fun.
    From WebMD, "Mirabegron may increase the amount of metoprolol in your blood by slowing down how quickly your liver processes these medicines.
    Your blood levels of metoprolol may increase and could cause toxic effects."


    I also had a more SCI related follow-up question. While metoprolol lowers blood pressures overall, does it ałso help keep a person's blood pressure lower during an episode of autonomic dysreflexia?

    I understand that metoprolol is taken once or twice daily and not at the time an episode of AD occurs (like how Nifedipine is taken during the AD to bring BP down) but I was wondering if it does help keep a person's BP from getting as high as it could during episodes of AD. I found some information online, but I wanted to ask the Spinalnurses. Is that something you've noticed in your SCI patients?

    Thank you for your help, Melissa
    Life is a lesson you learn when you're through.

  • #2
    Kudos for checking your drug-drug interactions! Shame on the urologist for not doing so. Your pharmacist should also have checked this when issuing the new drug. Of course the former only works if you get all meds from the same pharmacy, but that is one of the things that a pharmacist should be doing when providing drug education/advice. A good pharmacist would contact the prescribing physician (of the new drug) to be sure they were aware of the interaction and still want to give this drug.

    What dosage of metoprolol are you taking?

    Have you contacted your PCP about this issue? I would assume this is the person who prescribed your metoprolol. They may want to adjust your dosage, or change you to a different anti-hypertensive that does not have this interaction.

    Metoprolol is a beta blocker, so is not very effective against autonomic dysreflexia. Alpha blockers (like dibenzyline) do this better, as do calcium channel blockers (nifedipine, etc.) and nitrates (nitroglycerine).

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


    • #3
      Thanks, KLD. I learned long ago to check for drug interactions. This isn't the first time I've caught one that the prescribing doctor didn't. Unfortunately the urologist was too busy saying Myrbetriq wasn't that great, that instilling Gentamicin in the bladder in a home setting is a bad idea, and discussing his interesting take on COVID-19.

      I do actually get all my meds at the same pharmacy and have for many years. I'm surprised that they didn't catch thIs issue. They are usually pretty good about most things.

      I am on 25mg of Metoprolol in both the morning and evening.

      I had not contacted my PCP regarding it yet. He was not actually the doctor that prescribed the Metoprolol, as that prescription was started by the doctor that worked with me when I was over in another hospital after having superior mesenteric artery syndrome.

      I'm supposed to have a scheduled medication check appointment soon, so I will make sure to ask him about this issue as well. Hopefully it will be soon as I'd like to start taking the Myrbetriq. The clinic in my town had actually switched to only one doctor working at a time for a 12 hour shift, and then cycling through all the doctors.

      It is too bad that the Metoprolol probably hasn't been helping much with my autonomic dysreflexia. That would've been a nice side effect.


      I looked up the Dibenzyline you mentioned as I had never heard of it before. It actually sounds as though it might be something that could help me. I do tend to have very hard urethral spasms when I am having autonomic dysreflexia.

      Does Dibenzyline function in a similar way to Metoprolol, or are they very different in what they are able to do? Helping with AD would be a wonderful bonus benefit if they work in a similar fashion.

      Thanks so much for all the information. Take care! Melissa
      Life is a lesson you learn when you're through.

      Comment


      • #4
        Dibenzyline and Metoprolol work in different ways, but both are used for hypertension management. Dibenzyline is is a long-acting, adrenergic, alpha-receptor blocking agent. Metoprolol is a beta-blocker which works by blocking the action of certain natural chemicals in your body (such as epinephrine) that can narrow blood vessels. Dibenzyline has a relatively quick on-set of effects, which is one reason that it is used for AD management sometimes, and because it is thought that AD is primarily caused by alpha adrenergic stimulation by the autonomic nervous system.

        Call your provider's office and see if they are offering telemedicine visits during this crisis time. This issue should not require an inperson office visit.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

        Comment

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