Moderate
Amlodipine × Metoprolol
Calcium channel blockers (dihydropyridines)×Selective β1-adrenoceptor blockers
Mechanism
Target combination in angina and hypertension. Amlodipine dilates vessels; metoprolol slows heart rate. The drugs compensate each other's reflex effects.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
Standard combination in ischaemic heart disease with hypertension. Check pulse and blood pressure 1–2 weeks after start. In patients with ejection fraction below 40%, watch for heart failure decompensation.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)– Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)– Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024