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Antiarrhythmics eg, propafenone, flecainide , beta-blockers eg, metoprolol , phenothiazines eg, thioridazine , selective serotonin reuptake inhibitor ssri antidepressants eg, fluoxetine , or tricyclic antidepressants eg, nortriptyline since the risk of their unwanted effects could be increased by zyban sustained-release tablets.

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Metoprolol is a beta 1selectivecardioselectiveadrenergic receptor blocking agentThis preferential effect is not absolutehoweverand at higher plasma concentrationsmetoprolol also inhibits beta 2adrenoreceptorschiefly located in the bronchial and vascular musculatureMetoprolol has no intrinsic sympathomimetic activityand membrane-stabilizing activity is detectable only at plasma concentrations much greater than required for beta-blockadeAnimal and human experiments indicate that metoprolol slows the sinus rate and decreases AV nodal conduction.

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