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[[Category: Drugs]][[Category: Beta blockers]]
[[Category: Drugs]][[Category: Beta blockers]]
[[:Category: Cardiovascular Drug | '''Cardiovascular Drug''']]
'''Drug class: [[:Category: Beta blockers | Beta blockers]]
'''Metoprolol Tartrate (LOPRESSOR)''' (中文：[[美托洛爾]])
==Pronunciation==
==Pronunciation==
===Metoprolol tartrate 100mg===
===Metoprolol tartrate 100mg===
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[[File:Metoprolol tartrate 50mg.mp3]]
[[File:Metoprolol tartrate 50mg.mp3]]


===Metoprolol succinate 200mg===
==Common Strengths of Metoprolol==
Metoprolol is available in the following strengths:
*Immediate-release tablets (Metoprolol tartrate): 25 mg, 50 mg, 100 mg [1]
*Extended-release tablets (metoprolol succinate): 25 mg, 50 mg, 100 mg, 200 mg [1]


===Metoprolol succinate 100mg===
==Drug Trade Name of Metoprolol==
 
The brand names for metoprolol include:
===Metoprolol succinate 50mg===
*Lopressor (immediate-release metoprolol tartrate tablets)
 
*Betaloc Zok (extended-release metoprolol succinate tablets) [1]
===Metoprolol succinate 25mg===
 
{| class="wikitable"
!style="text-align: left" | Generic Name:
|Metoprolol Tartrate, Metoprolol succinate
|-
!style="text-align: left"| Class:
|Cardiovascular Drug
|-
!style="text-align: left"| Subclass:
|Beta blocker
|}
 
==Drug Name==
{| class="wikitable"
!Generic Name 藥物化學名稱
!Brand Name
|-
| Metoprolol Tartrate Tablet 50mg
| rowspan="2" | LOPRESSOR
|-
| Metoprolol Tartrate Tablet 100mg
|-
| Metoprolol Succinate Tablet 25mg
| rowspan="4" | BETALOC ZOK
|-
| Metoprolol Succinate Tablet 50mg
|-
| Metoprolol Succinate Tablet 100mg
|-
| Metoprolol Succinate Tablet 200mg
|}


==Mechanism of Action==
==Mechanism of Action==
Metoprolol is a β1-selective (cardio-selective) beta-blocker. It works by blocking the action of epinephrine (adrenaline) on beta-1 receptors in the heart. This slows the heart rate, reduces force of heart contractions, oxygen demand and decreases blood pressure.
Metoprolol is a β1-selective (cardioselective) beta-blocker. It works by blocking the action of epinephrine (adrenaline) on beta-1 receptors in the heart. This slows the heart rate, reduces force of heart contractions, oxygen demand and decreases blood pressure. [1][3]


==Route of Administration==
==Route of Administration==
Metoprolol is available for:
Metoprolol is available for:
*Oral administration as immediate-release and extended-release tablets
*Oral administration as immediate-release and extended-release tablets
*Intravenous injection (given by healthcare providers)
*Intravenous injection (given by healthcare providers) [1][2]


==Dosages==
==Dosages==
*Hypertension
*Hypertension
**Immediate-release: Typical starting 50 mg once daily, up to 400 mg/day maximum
**Immediate-release: Typical starting 50 mg once daily, up to 400 mg/day maximum
**Extended-release: Typical starting 100 mg once daily, up to 400 mg/day maximum
**Extended-release: Typical starting 100 mg once daily, up to 400 mg/day maximum [1]
*Heart failure: dosage not specified
*Heart failure: dosage not specified
**Immediate-release: Typical 25-100 mg twice daily
**Immediate-release: Typical 25-100 mg twice daily
**Extended-release: Typical 25-200 mg once daily
**Extended-release: Typical 25-200 mg once daily [3]
*Diabetic kidney disease: Dosage not specified, adjust based on patient response.
*Diabetic kidney disease: Dosage not specified, adjust based on patient response.


==Side Effects==
==Side Effects==
The following definitions of frequencies are used:
Very common ≥ 1/10
Common ≥ 1/100 to < 1/10
Uncommon ≥1/1,000 to <1/100
Rare ≥ 1/10,000 to < 1/1,000
Very rare < 1/10,000
{| class="wikitable"
{| class="wikitable"
!style="text-align: left"| Frequency
!style="text-align: left"| Frequency
!Adverse reactions
!Adverse reactions
|-
|-
| '''Very common
| '''Very common (≥1/10)
| Bradycardia (slow heart rate)
| Bradycardia (slow heart rate)
|-
|-
| rowspan="4" |'''Common
| rowspan="4" |'''Common (≥1/100 to <1/10)
| Dizziness
| Dizziness
|-
|-
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| Memory problems
| Memory problems
|-
|-
| Diarrhea
| Diarrhea [1][2]
|-
|-
| rowspan="4" |'''Uncommon
| rowspan="4" |'''Uncommon (≥1/1,000 to <1/100)
| Depression
| Depression
|-
|-
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| Insomnia
| Insomnia
|-
|-
| Rash
| Rash [2]
|-
|-
| '''Rare
| '''Rare (≥1/10,000 to <1/1,000)
| Nightmares
| Nightmares [2]
|}
|}


==Pharmacokinetics==
==Pharmacokinetics==
*Well absorbed from GI tract
*Well absorbed from GI tract
*Peak plasma levels in 2-4 hours
*Extensively metabolized in liver
*Extensively metabolized in liver
*Elimination half-life 6-7 hours
*Elimination half-life 6-7 hours
*Excreted in urine
*Excreted in urine [3]


==Drug Management==
==Drug Management==
'''Safety
'''Safety


Metoprolol has a boxed warning about not stopping it suddenly, as it may worsen chest pain, increase blood pressure, or cause a heart attack. Stopping should be done gradually under medical supervision.
Metoprolol has a boxed warning about not stopping it suddenly, as it may worsen chest pain, increase blood pressure, or cause a heart attack. Stopping should be done gradually under medical supervision. [1]


Contraindicated in heart block, sick sinus syndrome, severe bradycardia, severe circulation problems, severe heart failure.
Contraindicated in heart block, sick sinus syndrome, severe bradycardia, severe circulation problems, severe heart failure.


Caution in asthma, COPD, diabetes, liver disease.
Caution in asthma, COPD, diabetes, liver disease. [1][2]


'''Pregnancy
'''Pregnancy


Metoprolol is classified as pregnancy category C. It should only be used if the potential benefit justifies the potential risk to the fetus.
Metoprolol is classified as pregnancy category C. It should only be used if the potential benefit justifies the potential risk to the fetus. [2]


'''Breastfeeding
'''Breast Feeding


Present in breast milk at low levels. Caution advised as it may cause effects in infant.
Present in breast milk at low levels. Caution advised as it may cause effects in infant. [2]


'''Children and Elderly
'''Children and Elderly
Line 136: Line 102:
''' Renal Impairment
''' Renal Impairment


No dosage adjustment provided in labeling. Use with caution in severe renal impairment.
No dosage adjustment provided in labeling. Use with caution in severe renal impairment. [2]


'''Monitoring Requirments
'''Monitoring Requirements


Monitor blood pressure, heart rate, signs of worsening heart failure, bronchospasm, and blood glucose levels (in diabetics) during metoprolol therapy.
Monitor blood pressure, heart rate, signs of worsening heart failure, bronchospasm, and blood glucose levels (in diabetics) during metoprolol therapy. [2][3]


'''Drug Interactions
'''Drug Interactions


Metoprolol can interact with calcium channel blockers, digoxin, epinephrine (adrenaline), antidepressants, antipsychotics, anesthetics, and many other drugs. Careful monitoring is required.
Metoprolol can interact with calcium channel blockers, digoxin, epinephrine (adrenaline), antidepressants, antipsychotics, anesthetics, and many other drugs. Careful monitoring is required. [1][2]


==FAQs==
==FAQs==
'''How should I take the tablet?
'''How should I take the tablet?
Take orally with or without food as prescribed. Swallow extended-release capsules whole.
 
Take orally with or without food as prescribed. Swallow extended-release capsules whole. [2]


'''What should I avoid while taking?
'''What should I avoid while taking?
Avoid driving or hazardous tasks until you know how metoprolol affects you. Avoid alcohol and decongestants as these may increase some side effects.
 
Avoid driving or hazardous tasks until you know how metoprolol affects you. Avoid alcohol and decongestants as these may increase some side effects. [2]


'''What happens if I miss a dose?
'''What happens if I miss a dose?
Take the missed dose as soon as you remember. If it's near the next dose time, skip the missed dose and continue your regular schedule. Do not double the dose.
 
Take the missed dose as soon as you remember. If it's near the next dose time, skip the missed dose and continue your regular schedule. Do not double the dose. [2]
 
==Reference==
[1] https://www.medicalnewstoday.com/articles/metoprolol-oral-tablet
 
[2] https://www.drugs.com/metoprolol.html
 
[3] https://go.drugbank.com/drugs/DB00264
 
[4] https://www.ncbi.nlm.nih.gov/books/NBK532923/
 
[5] https://www.webmd.com/drugs/2/drug-11207/metoprolol-tartrate-oral/details

Latest revision as of 22:58, 4 September 2024


Cardiovascular Drug

Drug class: Beta blockers

Metoprolol Tartrate (LOPRESSOR) (中文：美托洛爾)

Pronunciation[edit]

Metoprolol tartrate 100mg[edit]

Metoprolol tartrate 50mg[edit]

Common Strengths of Metoprolol[edit]

Metoprolol is available in the following strengths:

  • Immediate-release tablets (Metoprolol tartrate): 25 mg, 50 mg, 100 mg [1]
  • Extended-release tablets (metoprolol succinate): 25 mg, 50 mg, 100 mg, 200 mg [1]

Drug Trade Name of Metoprolol[edit]

The brand names for metoprolol include:

  • Lopressor (immediate-release metoprolol tartrate tablets)
  • Betaloc Zok (extended-release metoprolol succinate tablets) [1]

Mechanism of Action[edit]

Metoprolol is a β1-selective (cardioselective) beta-blocker. It works by blocking the action of epinephrine (adrenaline) on beta-1 receptors in the heart. This slows the heart rate, reduces force of heart contractions, oxygen demand and decreases blood pressure. [1][3]

Route of Administration[edit]

Metoprolol is available for:

  • Oral administration as immediate-release and extended-release tablets
  • Intravenous injection (given by healthcare providers) [1][2]

Dosages[edit]

  • Hypertension
    • Immediate-release: Typical starting 50 mg once daily, up to 400 mg/day maximum
    • Extended-release: Typical starting 100 mg once daily, up to 400 mg/day maximum [1]
  • Heart failure: dosage not specified
    • Immediate-release: Typical 25-100 mg twice daily
    • Extended-release: Typical 25-200 mg once daily [3]
  • Diabetic kidney disease: Dosage not specified, adjust based on patient response.

Side Effects[edit]

Frequency Adverse reactions
Very common (≥1/10) Bradycardia (slow heart rate)
Common (≥1/100 to <1/10) Dizziness
Fatigue
Memory problems
Diarrhea [1][2]
Uncommon (≥1/1,000 to <1/100) Depression
Confusion
Insomnia
Rash [2]
Rare (≥1/10,000 to <1/1,000) Nightmares [2]

Pharmacokinetics[edit]

  • Well absorbed from GI tract
  • Peak plasma levels in 2-4 hours
  • Extensively metabolized in liver
  • Elimination half-life 6-7 hours
  • Excreted in urine [3]

Drug Management[edit]

Safety

Metoprolol has a boxed warning about not stopping it suddenly, as it may worsen chest pain, increase blood pressure, or cause a heart attack. Stopping should be done gradually under medical supervision. [1]

Contraindicated in heart block, sick sinus syndrome, severe bradycardia, severe circulation problems, severe heart failure.

Caution in asthma, COPD, diabetes, liver disease. [1][2]

Pregnancy

Metoprolol is classified as pregnancy category C. It should only be used if the potential benefit justifies the potential risk to the fetus. [2]

Breast Feeding

Present in breast milk at low levels. Caution advised as it may cause effects in infant. [2]

Children and Elderly

  • Children: Dosage not established
  • Elderly: May need lower doses due to age-related decreased kidney function

Renal Impairment

No dosage adjustment provided in labeling. Use with caution in severe renal impairment. [2]

Monitoring Requirements

Monitor blood pressure, heart rate, signs of worsening heart failure, bronchospasm, and blood glucose levels (in diabetics) during metoprolol therapy. [2][3]

Drug Interactions

Metoprolol can interact with calcium channel blockers, digoxin, epinephrine (adrenaline), antidepressants, antipsychotics, anesthetics, and many other drugs. Careful monitoring is required. [1][2]

FAQs[edit]

How should I take the tablet?

Take orally with or without food as prescribed. Swallow extended-release capsules whole. [2]

What should I avoid while taking?

Avoid driving or hazardous tasks until you know how metoprolol affects you. Avoid alcohol and decongestants as these may increase some side effects. [2]

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it's near the next dose time, skip the missed dose and continue your regular schedule. Do not double the dose. [2]

Reference[edit]

[1] https://www.medicalnewstoday.com/articles/metoprolol-oral-tablet

[2] https://www.drugs.com/metoprolol.html

[3] https://go.drugbank.com/drugs/DB00264

[4] https://www.ncbi.nlm.nih.gov/books/NBK532923/

[5] https://www.webmd.com/drugs/2/drug-11207/metoprolol-tartrate-oral/details

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