Increased effect of metoprolol amiodarone, cimetidine, diltiazem, nifedipine, nicardipine, verapamil, flecainide, hydralazine, MAO inhibitors, quinidine, ciprofloxacin, propafenone, oral contraeptives, fluoxetine, sertraline.
Decreased effect of metoprolol
NSAIDS, salycylates, barbiturates, rifampin, clonidine.
The dosage and
frequency depend upon the individuals metabolism and the drug being used.
There are no substitutes to beta-blockers.