Possible Interaction: Epinephrine and Metoprolol

“The threshold values of ADP and adrenaline for irreversible platelet aggregation were significantly higher for pindolol and metoprolol than for propranolol.”

“During metoprolol the adrenaline increase was even more pronounced.”

“Propranolol, but not metoprolol , prevented this effect of adrenaline.”

“Propranolol, but not metoprolol , reversed this insulin-antagonistic effeet of adrenaline.”

“Reasons for exclusion were an ejection fraction (< 30%, SA- and AV-block or simultaneous application of epinephrine and metoprolol.”

“Fasting blood glucose and insulin concentrations as well as mean plasma diurnal levels of insulin, growth hormone, testosterone and cortisol were similar after placebo and metoprolol treatment, whereas noradrenaline and adrenaline levels were significantly increased after metoprolol.”

“ Metoprolol treatment did not influence the resting levels of the fibrinolytic variables studied, but tended to enhance the t-PA response to CWT and further reduce PAI-1 during adrenaline infusion.”

“Plasma adrenaline levels were reduced one week after withdrawal of metoprolol treatment.”

“3 During psychic stress the plasma concentration of adrenaline rose significantly by 135% after labetalol, by 110% after metoprolol and by 83% after propranolol.”

“With metoprolol, epinephrine levels at rest and submaximal work loads were elevated; no effect was apparent at maximal loads.”

“… metoprolol … adrenaline (0.09 microgram x kg-1 x min-1, infused at 2, 3.5 and 5 hrs after metoprolol administration) on the diastolic blood … probably reflecting a difference in degree of action of metoprolol on the vascular bed for Durules and regular metoprolol tablets in identical doses.”