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In patients with solid tumors, exposure to metoprolol, another cyp2d6 substrate, was increased by 30 when given on day 15 of gefitinib dosing 500 mg daily ; the effect of gefitinib on cyp2d6-dependent drugs is only likely to be clinically relevant when given with cyp2d6 substrates with a narrow therapeutic index or that are individually dose titrated such as propranolol.

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Because of its relative beta 1 cardio-selectivity, however, metoprolol succinate extended-release tablet may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment.

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Thus, using fish oil in conjunction with metoprolol may cause blood pressure to become too low.

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if patients experience symptomatic bradycardia, reduce the dose of metoprolol succinate extended-release tablet.

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