Metoprolol Tartrate: Difference between revisions
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*Extended-release tablets (metoprolol succinate): 25mg, 50mg, 100mg, 200mg <ref name="a" /> | *Extended-release tablets (metoprolol succinate): 25mg, 50mg, 100mg, 200mg <ref name="a" /> | ||
==Drug | ==Drug trade name of Metoprolol== | ||
The brand names for metoprolol include: | |||
*Lopressor (immediate-release metoprolol tartrate tablets) | |||
*Betaloc Zok (extended-release metoprolol succinate tablets) <ref name="a" /> | |||
==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" /> | 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> | ||
==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" /> | *Intravenous injection (given by healthcare providers) <ref name="a" /> <ref name="b">https://www.drugs.com/metoprolol.html</ref> | ||
==Dosages== | ==Dosages== | ||
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*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 <ref name="c" /> | ||
*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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| Memory problems | | Memory problems | ||
|- | |- | ||
| Diarrhea <ref name="a" /> | | Diarrhea <ref name="a" /> <ref name="b" /> | ||
|- | |- | ||
| rowspan="4" |'''Uncommon | | rowspan="4" |'''Uncommon | ||
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| Insomnia | | Insomnia | ||
|- | |- | ||
| Rash | | Rash <ref name="b" /> | ||
|- | |- | ||
| '''Rare | | '''Rare | ||
| Nightmares | | Nightmares <ref name="b" /> | ||
|} | |} | ||
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*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 <ref name="c" /> | ||
==Drug Management== | ==Drug Management== | ||
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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" /> | Caution in asthma, COPD, diabetes, liver disease. <ref name="a" /> <ref name="b" /> | ||
'''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. <ref name="b" /> | ||
'''Breastfeeding | '''Breastfeeding | ||
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. <ref name="b" /> | ||
'''Children and Elderly | '''Children and Elderly | ||
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''' 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. <ref name="b" /> | ||
'''Monitoring | '''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. <ref name="b" /> <ref name="c" /> | ||
'''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" /> | 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" /> | ||
==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. <ref name="b" /> | ||
'''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. <ref name="b" /> | ||
'''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. <ref name="b" /> | ||
==Citations== | ==Citations== | ||
Revision as of 03:03, 7 June 2024
Pronunciation
Metoprolol tartrate 100mg
Metoprolol tartrate 50mg
| Generic Name: | Metoprolol Tartrate, Metoprolol succinate |
|---|---|
| Class: | Cardiovascular Drug |
| Subclass: | Beta blocker |
Common Strengths of Metoprolol
Metoprolol is available in the following strengths:
- Immediate-release tablets (Metoprolol tartrate): 25mg, 37.5mg, 50mg, 75mg, 100mg [1]
- Extended-release tablets (metoprolol succinate): 25mg, 50mg, 100mg, 200mg [1]
Drug trade name of Metoprolol
The brand names for metoprolol include:
- Lopressor (immediate-release metoprolol tartrate tablets)
- Betaloc Zok (extended-release metoprolol succinate tablets) [1]
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. [1] [2]
Route of Administration
Metoprolol is available for:
- Oral administration as immediate-release and extended-release tablets
- Intravenous injection (given by healthcare providers) [1] [3]
Dosages
- 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 [2]
- Diabetic kidney disease: Dosage not specified, adjust based on patient response.
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
| Frequency | Adverse reactions |
|---|---|
| Very common | Bradycardia (slow heart rate) |
| Common | Dizziness |
| Fatigue | |
| Memory problems | |
| Diarrhea [1] [3] | |
| Uncommon | Depression |
| Confusion | |
| Insomnia | |
| Rash [3] | |
| Rare | Nightmares [3] |
Pharmacokinetics
- Well absorbed from GI tract
- Extensively metabolized in liver
- Elimination half-life 6-7 hours
- Excreted in urine [2]
Drug Management
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] [3]
Pregnancy
Metoprolol is classified as pregnancy category C. It should only be used if the potential benefit justifies the potential risk to the fetus. [3]
Breastfeeding
Present in breast milk at low levels. Caution advised as it may cause effects in infant. [3]
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. [3]
Monitoring Requirements
Monitor blood pressure, heart rate, signs of worsening heart failure, bronchospasm, and blood glucose levels (in diabetics) during metoprolol therapy. [3] [2]
Drug Interactions
Metoprolol can interact with calcium channel blockers, digoxin, epinephrine (adrenaline), antidepressants, antipsychotics, anesthetics, and many other drugs. Careful monitoring is required. [1] [3]
FAQs
How should I take the tablet?
Take orally with or without food as prescribed. Swallow extended-release capsules whole. [3]
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. [3]
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. [3]
