Lopressor (Metoprolol)
Class and Category of Drug
Before you buy Lopressor (Metoprolol) online, read common information about the medication.
Chemical class: Beta1-adrenergic antagonist
Therapeutic class: Antianginal, antihypertensive, MI prophylaxis and treatment
Pregnancy category: C
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Drug Indications and Dosages
Before purchase Lopressor (Metoprolol) online , you must read how it works.
To manage hypertension, alone or with other antihypertensives
E.R. Tablets (Metoprolol Succinate)
Adults. Initial: 25 to 100 mg daily, adjusted weekly as prescribed. Maximum: 400 mg daily.
E.R. Tablets (Metoprolol Tartrate)
Adults. Maintenance: 100 to 400 mg daily to maintain blood pressure control after therapeutic level has been achieved with immediate-release tablets.
Tablets (Metoprolol Tartrate)
Adults. Initial: 100 mg daily, adjusted weekly as prescribed. Maximum: 450 mg daily as a single dose or in divided doses.
To treat acute MI or evolving acute MI
Tablets (Metoprolol Tartrate), Intravenous Injection (Metoprolol Tartrate)
Adults. Initial: 5 mg by intravenous bolus every 2 min for 3 doses followed by 50 mg P.O. for patients who tolerate total intravenous dose (25 to 50 mg P.O. for patients who can't tolerate total intravenous dose) every 6 hr for 48 hr, starting 15 min after final intravenous dose; after 48 hr, 100 mg b.i.d. followed by maintenance dosage. Maintenance: 100 mg P.O. b.i.d. for at least 3 mo.
To treat angina pectoris and chronic stable angina
E.R. Tablets (Metoprolol Succinate)
Adults. 100 mg daily, increased weekly as prescribed. Maximum: 400 mg daily as a single dose or in divided doses.
E.R. Tablets (Metoprolol Tartrate)
Adults. Initial: 100 mg daily, adjusted weekly as prescribed. Maximum: 450 mg daily.
Tablets (Metoprolol Tartrate) Adults. Initial: 50 mg b.i.d., adjusted weekly as prescribed. Maximum: 450 mg daily.
To treat stable, symptomatic (New York Heart Association [NYHA] Class II or III), ischemic, hypertensive, or cardiomyopathic heart failure
E.R. Tablets (Metoprolol Succinate)
Adults. Initial: 25 mg daily (NYHA Class II) or 12.5 mg daily (NYHA Class III or more severe heart failure) for 2 wk. Then dosage doubled every 2 wk as tolerated. Maximum: 200 mg daily.
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Contraindications of Drug
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Acute heart failure; pulse less than 45 beats/ minute; cardiogenic shock; hypersensitivity to metoprolol, its components, or other beta blockers; pheochromocytoma; second-or third-degree atrioventricular block; severe peripheral arterial disorders; sick sinus syndrome
Generic Drug Interactions
Drugs
aluminum salts, barbiturates, calcium salts, cholestyramine, colestipol, nonsteroidal anti-inflammatory drugs (NSAIDs), rifampin, salicylates, sulfinpyrazone: Decreased therapeutic effects of metoprolol
amiodarone, digoxin, diltiazem, verapamil: Increased risk of complete atrioventricular block
calcium channel blockers: Increased risk of heart failure and increased effects of both drugs
cimetidine: Increased metoprolol level
clonidine: Increased risk of hypotension; increased risk of rebound hypertension when clonidine is discontinued
digoxin: Decreased heart rate and slowed atrioventricular conduction
estrogens: Possibly decreased antihypertensive effect of metoprolol
general anesthetics: Increased risk of hypotension and heart failure
insulin, oral antidiabetic drugs: Decreased blood glucose control, possibly masking of signs and symptoms of hypoglycemia (by metoprolol)
lidocaine: Increased risk of lidocaine toxicity
MAO inhibitors: Risk of hypertension
neuromuscular blockers: Possibly enhanced and prolonged neuromuscular blockade other antihypertensives: Additive hypotensive effect
phenothiazines: Possibly increased blood levels of both drugs
propafenone: Increased blood level and half-life of metoprolol
sympathomimetics, xanthines: Possibly decreased therapeutic effects of both drugs
Foods
all foods: Increased bioavailability of metoprolol
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Drugs Adverse Reactions
Central Nervous System: Anxiety, confusion, depression, dizziness, drowsiness, fatigue, hallucinations, headache, insomnia, weakness
Cardiovascular: Angina, arrhythmias (including atrioventricular block and bradycardia), chest pain, decreased HDL level, increased triglyceride levels, gangrene of extremity, heart failure, hypertension, orthostatic hypotension
Eyes, Ears, Nose, And Throat: Nasal congestion, rhinitis, taste disturbance
Gastrointestinal: Constipation, diarrhea, hepatitis, nausea, vomiting
Genitourinary: Impotence
Hematologic: Leukopenia, thrombocytopenia
Musculoskeletal: Arthralgia, back pain, myalgia
Respiratory: Bronchospasm, dyspnea
Skin: Diaphoresis, photosensitivity, rash, urticaria, worsening of psoriasis
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Nursing Considerations for Generic Drugs
• Use metoprolol with extreme caution in patients with bronchospastic disease who don't respond to or can't tolerate other antihypertensives. Expect to give smaller doses more often to avoid the higher plasma levels in longer dosage intervals.
• Use cautiously in patients with hypertension or angina who have congestive heart failure because beta blockers such as metoprolol can further depress myocardial contractility, worsening heart failure.
• For patient with acute MI who can't tolerate initial dosage or who delays treatment, start with maintenance dosage, as prescribed and tolerated.
• Before starting therapy for heart failure, expect to give a diuretic, an ACE inhibitor, and digoxin to stabilize patient.
• If patient has pheochromocytoma, alpha blocker therapy should start first, followed by metoprolol to prevent paradoxical increase in blood pressure from attenuation of beta-mediated vasodilation in skeletal muscle.
• Be aware that metoprolol dosage for heart failure is highly individualized. Monitor patient for evidence of worsening heart failure during dosage increases. If heart failure worsens, expect to increase diuretic dosage and possibly decrease metoprolol dosage or temporarily discontinue drug, as prescribed. Metoprolol dosage shouldn't be increased until worsening heart failure has been stabilized.
• If patient with heart failure develops symptomatic bradycardia, expect to decrease the metoprolol dosage.
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Metoprolol
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
British Pharmacopoeia, 2008 edition: Metoprolol Injection; Metoprolol Tartrate Tablets;
The United States Pharmacopeia 31, 2008: Metoprolol Succinate Extended-Release Tablets; Metoprolol Tartrate and Hydrochlorothiazide Tablets; Metoprolol Tartrate Injection; Metoprolol Tartrate Oral Solution; Metoprolol Tartrate Oral Suspension; Metoprolol Tartrate Tablets.
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