RiteMED Metoprolol

Metoprolol tartrate

HTN, angina pectoris, cardiac arrhythmias, MI. Adjunct to treatment of thyrotoxicosis. Prevention of migraine.

HTN, angina pectoris Initially 50-100 mg daily once or in divided doses, dose may be increased at wkly intervals to max of 450 mg daily. Cardiac arrhythmias 100-150 mg per day in 2 or 3 divided doses, may be increased up to 300 mg daily in divided doses. MI early treatment 50 mg ever 6 hr for 48 hr in patients who tolerate full IV dose, given 15 min after the last IV dose. Maintenance dose: 100 mg bid. 25-50 mg every 6 hr after 15 min of last IV dose in patients who cannot tolerate full IV dose. Late treatment 100 mg bid, continued for at least 3 mth. Adjunct to treatment of thyrotoxicosis 150-200 mg in 3 or 4 divided doses daily, may be increased up to 400 mg daily. Prevention of migraine 100 mg as single dose in morning, may be increased to 200 mg daily in 2 divided doses (morning & evening).

May be taken with or without food.

Hypersensitivity to metoprolol or any other β-blocker. Severe bronchial asthma or history of severe bronchospasm; hypotension; metabolic acidosis; HTN & angina patients w/ sinus bradycardia, heart block > 1st degree, cardiogenic shock, overt or decompensated cardiac failure, sick sinus syndrome, severe peripheral arterial circulatory disorders, untreated pheochromocytoma. Acute MI w/ Heart rate <45 beats/min, 2nd & 3rd-degree heart block, significant 1st degree heart block (P-R interval ≥0.24 sec), systolic BP <100 mmHg, Moderate to severe cardiac failure.

Cardiac failure. MI; bradycardia; hypotension. Patients w/ DM, particularly those who are receiving insulin or oral hypoglycemic agents; known to have, or suspected to have pheochromocytoma. Discontinue metoprolol if heart failure occurs or persists despite appropriate treatment. Use the lowest possible dose in patients w/ bronchospastic disease who do not respond or cannot tolerate other antihypertensive treatment. Slows AV conduction & may produce heart block. W/draw β-blockers prior to major surgery. May mask certain clinical signs (eg, tachycardia) of hyperthyroidism. Patients w/ history of severe anaphylactic reaction to allergens. Observe for potential ocular effects. Impaired hepatic failure. Avoid operating machinery or engaging in other tasks requiring alertness. Pregnancy & lactation. Childn.

Arterial insufficiency (eg, Raynaud's phenomenon), bradycardia, cold extremities, cardiac arrhythmias, cardiac conduction disorders, chest pain, claudication, CHF, decreased HDL, edema, 1st-degree heart block, hypotension, increased triglycerides, orthostatic hypotension occasionally w/ syncope, palpitations, peripheral edema, precordial pain, 2nd- or 3rd-degree heart block; decreased libido, hypoglycemia, unstable diabetes, wt gain; increased alkaline phosphatase, transaminases, LDH, BUN, serum creatinine, uric acid; abdominal pain, constipation, diarrhea, digestive tract disorders, dry mouth, flatulence, gastric pain, heartburn, hiccups, nausea, retroperitoneal fibrosis, vomiting, xerostomia; arthritis, general weakness, muscle cramps, musculoskeletal pain, polymyalgia-like syndrome, restless legs; confusion, decreased alertness, depression, dizziness, full headedness, hallucination, headache, impotence, increased dreaming, insomnia, lethargy, mental confusion, nervousness, nightmares, paresthesia, personality disorder, short-term memory loss, sleep disturbances, somnolence, tiredness, vertigo; bronchospasm, dyspnea, rhinitis, shortness of breath, wheezing; alopecia, dry skin, hyperhidrosis, pruritus, rash, sweating; blurred vision, dry eyes, eye irritation, hearing disorders (eg, hypoacusis or deafness), tinnitus, visual disturbances; Peyronie's disease, agranulocytosis, fatigue, increased or decreased antinuclear factor (ANF) levels, lassitude, thrombocytopenia.

Additive effect w/ catecholamine-depleting drugs (eg, reserpine). Potentiated depressant effects w/ Ca channel blockers (eg, verapamil, diltiazem), & effects on heart rate & AV conduction w/ amiodarone, propafenone & other class I antiarrhythmic drugs (eg, quinidine, disopyramide). W/draw several days before clonidine use. Increased plasma conc w/ potent inhibitors of CYP2D6 antidepressants (eg, fluoxetine, paroxetine, bupropion), antipsychotics (eg, thioridazine), antiarrhythmics (eg, quinidine, propafenone), antiretrovirals (eg, ritonavir), antihistamines (eg, diphenhydramine), antimalarials (eg, hydroxychloroquine, quinidine), antifungals (eg, terbinafine) & medications for stomach ulcers (eg, cimetidine). May result in excessive bradycardia &/or increased AV conduction time w/ digitalis glycosides. Enhanced cardiopressant effect w/ general anesth. Reduced plasma conc w/ hepatic enzyme inducers (eg, rifampicin). Increased or prolonged hypoglycemia w/ insulin. May antagonize hypoglycemic effects of sulfonylureas. May reduce clearance of lidocaine. Enhanced hypotensive effect w/ nitroglycerin. Decreased antihypertensive effect w/ NSAIDs (eg, indomethacin). May increase acute postural hypotension following the 1st dose of prazosin. May antagonize the β1 effects of sympathomimetic agents. Concomitant ingestion w/ alcohol may increase blood alcohol conc. Additive effects w/ other antihypertensive drugs. May affect peripheral circulation w/ drug w/ similar activity eg, ergotamine. Coadministration w/ sympathetic ganglion blocking agents, other β-blockers (including eye drops) or MAOIs.

Beta-Blockers

C07AB02 - metoprolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.

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