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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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===Metoprolol tartrate 50mg===
===Metoprolol tartrate 50mg===
[[File:Metoprolol tartrate 50mg.mp3]]
[[File:Metoprolol tartrate 50mg.mp3]]
{| 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
|}


==Common Strengths of Metoprolol==
==Common Strengths of Metoprolol==
Metoprolol is available in the following strengths:
Metoprolol is available in the following strengths:
*Immediate-release tablets (Metoprolol tartrate): 25mg, 50mg, 100mg <ref name="a">https://www.medicalnewstoday.com/articles/metoprolol-oral-tablet</ref>
*Immediate-release tablets (Metoprolol tartrate): 25 mg, 50 mg, 100 mg [1]
*Extended-release tablets (metoprolol succinate): 25mg, 50mg, 100mg, 200mg <ref name="a" />
*Extended-release tablets (metoprolol succinate): 25 mg, 50 mg, 100 mg, 200 mg [1]


==Drug trade name of Metoprolol==
==Drug Trade Name of Metoprolol==
The brand names for metoprolol include:
The brand names for metoprolol include:
*Lopressor (immediate-release metoprolol tartrate tablets)
*Lopressor (immediate-release metoprolol tartrate tablets)
*Betaloc Zok (extended-release metoprolol succinate tablets) <ref name="a" />
*Betaloc Zok (extended-release metoprolol succinate tablets) [1]


==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. <ref name="a" /> <ref name="c">https://go.drugbank.com/drugs/DB00264</ref>
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) <ref name="a" /> <ref name="b">https://www.drugs.com/metoprolol.html</ref>
*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 <ref name="a" />
**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 <ref name="c" />
**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.


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!Adverse reactions
!Adverse reactions
|-
|-
| '''Very common (≥ 1/10)
| '''Very common (≥1/10)
| Bradycardia (slow heart rate)
| Bradycardia (slow heart rate)
|-
|-
| rowspan="4" |'''Common (≥ 1/100 to < 1/10)
| rowspan="4" |'''Common (≥1/100 to <1/10)
| Dizziness
| Dizziness
|-
|-
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| Memory problems
| Memory problems
|-
|-
| Diarrhea <ref name="a" /> <ref name="b" />
| Diarrhea [1][2]
|-
|-
| rowspan="4" |'''Uncommon (≥1/1,000 to <1/100)
| rowspan="4" |'''Uncommon (≥1/1,000 to <1/100)
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| Insomnia
| Insomnia
|-
|-
| Rash <ref name="b" />
| Rash [2]
|-
|-
| '''Rare (1/10,000 to < 1/1,000)
| '''Rare (≥1/10,000 to <1/1,000)
| Nightmares <ref name="b" />
| 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 <ref name="c" />
*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. <ref name="a" />
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. <ref name="a" /> <ref name="b" />
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. <ref name="b" />
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. <ref name="b" />
Present in breast milk at low levels. Caution advised as it may cause effects in infant. [2]


'''Children and Elderly
'''Children and Elderly
Line 106: Line 102:
''' Renal Impairment
''' Renal Impairment


No dosage adjustment provided in labeling. Use with caution in severe renal impairment. <ref name="b" />
No dosage adjustment provided in labeling. Use with caution in severe renal impairment. [2]


'''Monitoring Requirements
'''Monitoring Requirements


Monitor blood pressure, heart rate, signs of worsening heart failure, bronchospasm, and blood glucose levels (in diabetics) during metoprolol therapy. <ref name="b" /> <ref name="c" />
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. <ref name="a" /> <ref name="b" />
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. <ref name="b" />
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. <ref name="b" />
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. <ref name="b" />
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/


==Citations==
[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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